Provider Demographics
NPI:1952634255
Name:COBURN, CHRISTINA DANIELLE (RN-BSN)
Entity Type:Individual
Prefix:MRS
First Name:CHRISTINA
Middle Name:DANIELLE
Last Name:COBURN
Suffix:
Gender:F
Credentials:RN-BSN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:98 PATCHOGUE DR
Mailing Address - Street 2:
Mailing Address - City:ROCKY POINT
Mailing Address - State:NY
Mailing Address - Zip Code:11778-9347
Mailing Address - Country:US
Mailing Address - Phone:631-284-3592
Mailing Address - Fax:
Practice Address - Street 1:98 PATCHOGUE DR
Practice Address - Street 2:
Practice Address - City:ROCKY POINT
Practice Address - State:NY
Practice Address - Zip Code:11778-9347
Practice Address - Country:US
Practice Address - Phone:631-284-3592
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-09-17
Last Update Date:2009-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY562328163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse