Provider Demographics
NPI:1922093699
Name:THORNHILL, CHRISTI MICHELLE (ACPNP)
Entity Type:Individual
Prefix:
First Name:CHRISTI
Middle Name:MICHELLE
Last Name:THORNHILL
Suffix:
Gender:F
Credentials:ACPNP
Other - Prefix:
Other - First Name:CHRISTI
Other - Middle Name:MICHELLE
Other - Last Name:DUTTON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:ACPNP
Mailing Address - Street 1:PO BOX 733784
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75373-3784
Mailing Address - Country:US
Mailing Address - Phone:682-885-6483
Mailing Address - Fax:
Practice Address - Street 1:801 7TH AVE
Practice Address - Street 2:
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76104-2733
Practice Address - Country:US
Practice Address - Phone:682-885-3953
Practice Address - Fax:682-885-7445
Is Sole Proprietor?:No
Enumeration Date:2005-09-19
Last Update Date:2021-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX568165363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX044333509Medicaid
TX044333507Medicaid
TX0443335-05Medicaid
TXTXB114570Medicare PIN
TX8C5807Medicare PIN
TX044333507Medicaid
TX8B5990Medicare ID - Type Unspecified