Provider Demographics
NPI:1891139416
Name:BROWN, CHRISTINA NICOLE (RN)
Entity Type:Individual
Prefix:
First Name:CHRISTINA
Middle Name:NICOLE
Last Name:BROWN
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 1:2345 REAGAN ST
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75219-3225
Mailing Address - Country:US
Mailing Address - Phone:214-999-1044
Mailing Address - Fax:214-296-4704
Practice Address - Street 1:2345 REAGAN ST
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75219-3225
Practice Address - Country:US
Practice Address - Phone:214-999-1044
Practice Address - Fax:214-296-4704
Is Sole Proprietor?:No
Enumeration Date:2013-04-25
Last Update Date:2013-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX778145163W00000X, 163WA0400X, 163WN0800X, 163WP0807X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
No163WA0400XNursing Service ProvidersRegistered NurseAddiction (Substance Use Disorder)
No163WN0800XNursing Service ProvidersRegistered NurseNeuroscience
No163WP0807XNursing Service ProvidersRegistered NursePsychiatric/Mental Health, Child & Adolescent
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX778145OtherSTATE BOARD OF NURSING