Provider Demographics
NPI:1841644713
Name:CRONK, CHRISTINA OLSON
Entity type:Individual
Prefix:
First Name:CHRISTINA
Middle Name:OLSON
Last Name:CRONK
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PROSPECT HILL COMMUNITY HEALTH CENTER
Mailing Address - Street 2:322 MAIN ST
Mailing Address - City:PROSPECT HILL
Mailing Address - State:NC
Mailing Address - Zip Code:27314-0001
Mailing Address - Country:US
Mailing Address - Phone:336-562-3311
Mailing Address - Fax:336-562-4444
Practice Address - Street 1:PROSPECT HILL COMMUNITY HEALTH CENTER
Practice Address - Street 2:322 MAIN ST
Practice Address - City:PROSPECT HILL
Practice Address - State:NC
Practice Address - Zip Code:27314-0001
Practice Address - Country:US
Practice Address - Phone:336-562-3311
Practice Address - Fax:336-562-4444
Is Sole Proprietor?:No
Enumeration Date:2016-04-18
Last Update Date:2019-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2019-00338207Q00000X
NC218500207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine