Healthcare Provider Details

I. General information

NPI: 1215573498
Provider Name (Legal Business Name): CHRISTINA TERESA HOLUB APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: CHRISTINA TERESA POLITO

II. Dates (important events)

Enumeration Date: 11/21/2019
Last Update Date: 12/07/2023
Certification Date: 12/07/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2645 MERIDIAN PKWY STE 323
DURHAM NC
27713-4232
US

IV. Provider business mailing address

35 SHELDON RD
DERRY NH
03038-5727
US

V. Phone/Fax

Practice location:
  • Phone: 984-227-8902
  • Fax: 844-813-6747
Mailing address:
  • Phone: 617-543-1421
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number072678-23
License Number StateNH
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberSP023766
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: