Healthcare Provider Details

I. General information

NPI: 1306499025
Provider Name (Legal Business Name): CHRISTEL-ANN B AUGUSTIN FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/22/2019
Last Update Date: 12/28/2022
Certification Date: 12/28/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

263 N MAIN ST
SPRING VALLEY NY
10977-3762
US

IV. Provider business mailing address

2 DICKENS ST
STONY POINT NY
10980-3653
US

V. Phone/Fax

Practice location:
  • Phone: 845-425-9600
  • Fax: 845-425-9602
Mailing address:
  • Phone: 845-323-7187
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number349420
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number736510
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: