Provider Demographics
NPI:1730658477
Name:NOVAK, CHRISTINE LENA (RN)
Entity Type:Individual
Prefix:
First Name:CHRISTINE
Middle Name:LENA
Last Name:NOVAK
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 302583
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78703-0044
Mailing Address - Country:US
Mailing Address - Phone:517-474-6577
Mailing Address - Fax:
Practice Address - Street 1:9301 HOG EYE RD UNIT 318
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78724-4608
Practice Address - Country:US
Practice Address - Phone:517-474-6577
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-11-23
Last Update Date:2018-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX808355163WH0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WH0200XNursing Service ProvidersRegistered NurseHome Health