Provider Demographics
NPI:1629585260
Name:FOREMAN, CHRISTINA DENISE (CRNP)
Entity Type:Individual
Prefix:MRS
First Name:CHRISTINA
Middle Name:DENISE
Last Name:FOREMAN
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:MRS
Other - First Name:CHRISTINA
Other - Middle Name:DENISE
Other - Last Name:FOREMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CRNP
Mailing Address - Street 1:4340 PARK HEIGHTS AVE
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21215-6725
Mailing Address - Country:US
Mailing Address - Phone:301-555-5555
Mailing Address - Fax:
Practice Address - Street 1:4340 PARK HEIGHTS AVE
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21215-6725
Practice Address - Country:US
Practice Address - Phone:410-542-8130
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-01-04
Last Update Date:2018-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR176902363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily