Provider Demographics
NPI:1659753689
Name:GARCIA, CHRISTINA M (AGACNP-BC)
Entity Type:Individual
Prefix:
First Name:CHRISTINA
Middle Name:M
Last Name:GARCIA
Suffix:
Gender:F
Credentials:AGACNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:74 TREBBE DR
Mailing Address - Street 2:
Mailing Address - City:MANCHESTER
Mailing Address - State:CT
Mailing Address - Zip Code:06040-2621
Mailing Address - Country:US
Mailing Address - Phone:203-687-3104
Mailing Address - Fax:
Practice Address - Street 1:74 TREBBE DR
Practice Address - Street 2:
Practice Address - City:MANCHESTER
Practice Address - State:CT
Practice Address - Zip Code:06040-2621
Practice Address - Country:US
Practice Address - Phone:203-687-3104
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-06-26
Last Update Date:2015-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT94277163WC0200X
CT6141363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care
No163WC0200XNursing Service ProvidersRegistered NurseCritical Care Medicine