Provider Demographics
NPI:1780867150
Name:PINKSTON, CHARIS OLYMPIA (RN)
Entity Type:Individual
Prefix:MS
First Name:CHARIS
Middle Name:OLYMPIA
Last Name:PINKSTON
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 1:19 W HICKORY ST
Mailing Address - Street 2:
Mailing Address - City:SPRING VALLEY
Mailing Address - State:NY
Mailing Address - Zip Code:10977-3633
Mailing Address - Country:US
Mailing Address - Phone:845-425-2198
Mailing Address - Fax:
Practice Address - Street 1:719 W NYACK RD
Practice Address - Street 2:STE. #27
Practice Address - City:WEST NYACK
Practice Address - State:NY
Practice Address - Zip Code:10994-2240
Practice Address - Country:US
Practice Address - Phone:845-358-2002
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-12-08
Last Update Date:2007-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY593777-1163WH0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WH0200XNursing Service ProvidersRegistered NurseHome Health