Provider Demographics
NPI:1760925507
Name:GARCIA, CHRISTIANE OPALKA (CRNP)
Entity Type:Individual
Prefix:
First Name:CHRISTIANE
Middle Name:OPALKA
Last Name:GARCIA
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1311 ALLENBY CT
Mailing Address - Street 2:
Mailing Address - City:BEL AIR
Mailing Address - State:MD
Mailing Address - Zip Code:21014-2740
Mailing Address - Country:US
Mailing Address - Phone:410-627-7086
Mailing Address - Fax:
Practice Address - Street 1:30A N MECHANIC ST
Practice Address - Street 2:
Practice Address - City:CUMBERLAND
Practice Address - State:MD
Practice Address - Zip Code:21502-2314
Practice Address - Country:US
Practice Address - Phone:240-362-7265
Practice Address - Fax:240-362-7266
Is Sole Proprietor?:No
Enumeration Date:2016-11-28
Last Update Date:2016-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR192337363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDR192337OtherMARYLAND NURSE PRACTITIONER LICENSE