Provider Demographics
NPI:1710388186
Name:DAVIES, CHRISTINE M (FNP)
Entity Type:Individual
Prefix:
First Name:CHRISTINE
Middle Name:M
Last Name:DAVIES
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:265 N HIGHLAND AVE STE 105
Mailing Address - Street 2:
Mailing Address - City:NYACK
Mailing Address - State:NY
Mailing Address - Zip Code:10960-1444
Mailing Address - Country:US
Mailing Address - Phone:845-721-2159
Mailing Address - Fax:845-512-8440
Practice Address - Street 1:265 N HIGHLAND AVE STE 105
Practice Address - Street 2:
Practice Address - City:NYACK
Practice Address - State:NY
Practice Address - Zip Code:10960-1444
Practice Address - Country:US
Practice Address - Phone:845-721-2159
Practice Address - Fax:845-512-8440
Is Sole Proprietor?:No
Enumeration Date:2014-09-04
Last Update Date:2015-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF338547-1363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily