Provider Demographics
NPI:1255912788
Name:LYTLE, CHRISTINA MARIE (FNP)
Entity type:Individual
Prefix:
First Name:CHRISTINA
Middle Name:MARIE
Last Name:LYTLE
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1074 GOLDEN PINE LN
Mailing Address - Street 2:
Mailing Address - City:MONUMENT
Mailing Address - State:CO
Mailing Address - Zip Code:80132-9347
Mailing Address - Country:US
Mailing Address - Phone:731-618-7597
Mailing Address - Fax:
Practice Address - Street 1:320 E FONTANERO ST STE 308
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80907-7526
Practice Address - Country:US
Practice Address - Phone:719-577-4200
Practice Address - Fax:719-442-6595
Is Sole Proprietor?:No
Enumeration Date:2021-04-16
Last Update Date:2024-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CORN.1678467163W00000X, 163W00000X
TN29773363LF0000X
CORXN.0106175-NP363LF0000X
COAPN.0997152-NP363LF0000X
MO2014039260163W00000X
TN171411163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse