Provider Demographics
NPI:1710119383
Name:DOERR, CHRISTINE A (APRN-BC)
Entity Type:Individual
Prefix:
First Name:CHRISTINE
Middle Name:A
Last Name:DOERR
Suffix:
Gender:F
Credentials:APRN-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:163 ENGLE ST
Mailing Address - Street 2:SUITE 202
Mailing Address - City:ENGLEWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:07631-2535
Mailing Address - Country:US
Mailing Address - Phone:201-280-8734
Mailing Address - Fax:201-266-6200
Practice Address - Street 1:163 ENGLE ST
Practice Address - Street 2:SUITE 202
Practice Address - City:ENGLEWOOD
Practice Address - State:NJ
Practice Address - Zip Code:07631-2535
Practice Address - Country:US
Practice Address - Phone:201-280-8734
Practice Address - Fax:201-266-6200
Is Sole Proprietor?:Yes
Enumeration Date:2009-08-17
Last Update Date:2013-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NJ00218700364SP0807X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364SP0807XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistPsychiatric/Mental Health, Child & Adolescent