MEDICARE: MS. NORMA M CHRISTIAN NURSE PRACTITIONER

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LA2200X	Adult Health Nurse Practitioner	304750	NY

General Provider Information

NPI Number	:	1326235888
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. NORMA M CHRISTIAN NURSE PRACTITIONER

Provider Business Mailing Address
First Line	:	2383 CEDAR ST
Second Line	:
City	:	SEAFORD
State	:	NY
Zip	:	11783-2907
Country	:	US
Telephone Number	:	646-670-5130
Fax Number	:	646-670-5121

Provider Business Practice Location Address
First Line	:	1628 EASTCHESTER RD
Second Line	:
City	:	BRONX
State	:	NY
Zip	:	10461-2663
Country	:	US
Telephone Number	:	646-670-5130
Fax Number	:	646-670-5121

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/28/2007
Last Update Date	:	12/30/2011

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