Provider Demographics
NPI:1245844893
Name:NEVINS, CHRISTINA DANIELLE (CRNP)
Entity type:Individual
Prefix:
First Name:CHRISTINA
Middle Name:DANIELLE
Last Name:NEVINS
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:503 HASTINGS AVE
Mailing Address - Street 2:
Mailing Address - City:WALLINGFORD
Mailing Address - State:PA
Mailing Address - Zip Code:19086-7041
Mailing Address - Country:US
Mailing Address - Phone:484-868-8258
Mailing Address - Fax:
Practice Address - Street 1:602 E BALTIMORE PIKE
Practice Address - Street 2:
Practice Address - City:MEDIA
Practice Address - State:PA
Practice Address - Zip Code:19063-1735
Practice Address - Country:US
Practice Address - Phone:484-868-8258
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-09-01
Last Update Date:2020-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASPO22311363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care