Provider Demographics
NPI:1932439890
Name:BACSA, CHRISTINE M (RN)
Entity Type:Individual
Prefix:
First Name:CHRISTINE
Middle Name:M
Last Name:BACSA
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:36000 DARNALL LOOP
Mailing Address - Street 2:ARMY PUBLIC HEALTH NURSING
Mailing Address - City:FORT HOOD
Mailing Address - State:TX
Mailing Address - Zip Code:76544-5095
Mailing Address - Country:US
Mailing Address - Phone:254-287-6879
Mailing Address - Fax:254-288-9383
Practice Address - Street 1:36000 DARNALL LOOP
Practice Address - Street 2:ARMY PUBLIC HEALTH NURSING
Practice Address - City:FORT HOOD
Practice Address - State:TX
Practice Address - Zip Code:76544-5095
Practice Address - Country:US
Practice Address - Phone:254-287-6879
Practice Address - Fax:254-288-9383
Is Sole Proprietor?:Yes
Enumeration Date:2009-12-28
Last Update Date:2009-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA8S233202163WC1500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC1500XNursing Service ProvidersRegistered NurseCommunity Health