Provider Demographics
NPI:1851934970
Name:EXUM, CHRISTINA LEE
Entity Type:Individual
Prefix:
First Name:CHRISTINA
Middle Name:LEE
Last Name:EXUM
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1309 CAROL ANN DR
Mailing Address - Street 2:
Mailing Address - City:KERRVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:78028-3414
Mailing Address - Country:US
Mailing Address - Phone:830-992-1557
Mailing Address - Fax:
Practice Address - Street 1:1309 CAROL ANN DR
Practice Address - Street 2:
Practice Address - City:KERRVILLE
Practice Address - State:TX
Practice Address - Zip Code:78028-3414
Practice Address - Country:US
Practice Address - Phone:830-992-1557
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-10-21
Last Update Date:2019-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP143568363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health