Provider Demographics
NPI:1649459728
Name:DAVIDSON, CHRISTINA LYNN (FNP-BC)
Entity type:Individual
Prefix:MRS
First Name:CHRISTINA
Middle Name:LYNN
Last Name:DAVIDSON
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12301 GRAPEFIELD RD
Mailing Address - Street 2:
Mailing Address - City:BASTIAN
Mailing Address - State:VA
Mailing Address - Zip Code:24314-4547
Mailing Address - Country:US
Mailing Address - Phone:276-688-4331
Mailing Address - Fax:276-688-4336
Practice Address - Street 1:12301 GRAPEFIELD RD
Practice Address - Street 2:
Practice Address - City:BASTIAN
Practice Address - State:VA
Practice Address - Zip Code:24314-4547
Practice Address - Country:US
Practice Address - Phone:276-688-4331
Practice Address - Fax:276-688-4336
Is Sole Proprietor?:No
Enumeration Date:2007-10-25
Last Update Date:2020-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0001268640163W00000X
WV62971163W00000X
VA0024174200363LF0000X
WVAPRN62971NP363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse