Provider Demographics
NPI:1629741335
Name:MEMPIN, CHRISTY A
Entity Type:Individual
Prefix:
First Name:CHRISTY
Middle Name:A
Last Name:MEMPIN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15955 FREDERICK RD APT 2449
Mailing Address - Street 2:
Mailing Address - City:ROCKVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20855-2317
Mailing Address - Country:US
Mailing Address - Phone:301-395-9092
Mailing Address - Fax:
Practice Address - Street 1:15955 FREDERICK RD APT 2449
Practice Address - Street 2:
Practice Address - City:ROCKVILLE
Practice Address - State:MD
Practice Address - Zip Code:20855-2317
Practice Address - Country:US
Practice Address - Phone:301-395-9092
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-07-28
Last Update Date:2021-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR249385163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse