Provider Demographics
NPI:1184092868
Name:BYNUMS, CHRISTINA KATHERINE (RN)
Entity type:Individual
Prefix:
First Name:CHRISTINA
Middle Name:KATHERINE
Last Name:BYNUMS
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 1:21651 117TH RD
Mailing Address - Street 2:
Mailing Address - City:CAMBRIA HEIGHTS
Mailing Address - State:NY
Mailing Address - Zip Code:11411-1513
Mailing Address - Country:US
Mailing Address - Phone:646-663-0322
Mailing Address - Fax:
Practice Address - Street 1:21651 117TH RD
Practice Address - Street 2:
Practice Address - City:CAMBRIA HEIGHTS
Practice Address - State:NY
Practice Address - Zip Code:11411-1513
Practice Address - Country:US
Practice Address - Phone:646-663-0322
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-09-11
Last Update Date:2025-01-22
Deactivation Date:2025-01-11
Deactivation Code:
Reactivation Date:2025-01-22
Provider Licenses
StateLicense IDTaxonomies
NY22707237163W00000X
NYF349337363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse