Provider Demographics
NPI:1518387885
Name:NUSSBAUM, CHRISTINA LYNNE (MD)
Entity type:Individual
Prefix:DR
First Name:CHRISTINA
Middle Name:LYNNE
Last Name:NUSSBAUM
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3 NEENAH CTR
Mailing Address - Street 2:
Mailing Address - City:NEENAH
Mailing Address - State:WI
Mailing Address - Zip Code:54956-3070
Mailing Address - Country:US
Mailing Address - Phone:920-830-5900
Mailing Address - Fax:920-830-5910
Practice Address - Street 1:800 RIVERSIDE DR
Practice Address - Street 2:
Practice Address - City:WAUPACA
Practice Address - State:WI
Practice Address - Zip Code:54981-1943
Practice Address - Country:US
Practice Address - Phone:715-258-1000
Practice Address - Fax:715-258-1042
Is Sole Proprietor?:No
Enumeration Date:2014-04-24
Last Update Date:2025-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV17013207P00000X
NC2017-00432207P00000X
WI85454207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC19UA0OtherBCBS OF NC
NCNN10190322OtherMEDICARE
NC1518387885Medicaid
NV207P00000XMedicaid