Provider Demographics
NPI:1255041729
Name:GITHU, CRISTY (CNM)
Entity type:Individual
Prefix:
First Name:CRISTY
Middle Name:
Last Name:GITHU
Suffix:
Gender:F
Credentials:CNM
Other - Prefix:
Other - First Name:CRISTY
Other - Middle Name:
Other - Last Name:GITHU
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:CNM
Mailing Address - Street 1:96 NORTH RD
Mailing Address - Street 2:
Mailing Address - City:NORTH HAMPTON
Mailing Address - State:NH
Mailing Address - Zip Code:03862-2131
Mailing Address - Country:US
Mailing Address - Phone:978-551-8504
Mailing Address - Fax:
Practice Address - Street 1:55 FOGG RD
Practice Address - Street 2:
Practice Address - City:WEYMOUTH
Practice Address - State:MA
Practice Address - Zip Code:02190-2432
Practice Address - Country:US
Practice Address - Phone:978-551-8504
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-11-25
Last Update Date:2023-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MARN2293348163WC1500X
FLCNM08394176B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes176B00000XOther Service ProvidersMidwife
No163WC1500XNursing Service ProvidersRegistered NurseCommunity Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
00000OtherNONE