Provider Demographics
NPI:1689920928
Name:HAIRE, CHRISTINNA JEAN (ACNP-BC)
Entity Type:Individual
Prefix:
First Name:CHRISTINNA
Middle Name:JEAN
Last Name:HAIRE
Suffix:
Gender:F
Credentials:ACNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:160 DENTAL CIRCLE
Mailing Address - Street 2:CAMPUS BOX 7075
Mailing Address - City:CHAPEL HILL
Mailing Address - State:NC
Mailing Address - Zip Code:27599-7075
Mailing Address - Country:US
Mailing Address - Phone:919-966-5201
Mailing Address - Fax:919-966-1743
Practice Address - Street 1:160 DENTAL CIR
Practice Address - Street 2:
Practice Address - City:CHAPEL HILL
Practice Address - State:NC
Practice Address - Zip Code:27599-0001
Practice Address - Country:US
Practice Address - Phone:919-966-5201
Practice Address - Fax:919-966-1743
Is Sole Proprietor?:No
Enumeration Date:2012-07-24
Last Update Date:2019-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC266094363LA2100X
OH295718363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH1689920928Medicaid