Healthcare Provider Details

I. General information

NPI: 1154788867
Provider Name (Legal Business Name): CHRISTIE LYNN ASTOR CNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/26/2016
Last Update Date: 02/27/2025
Certification Date: 02/27/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7700 WASHINGTON VILLAGE DR STE 120
CENTERVILLE OH
45459-4071
US

IV. Provider business mailing address

136 S LUDLOW ST
DAYTON OH
45402-1813
US

V. Phone/Fax

Practice location:
  • Phone: 937-425-4144
  • Fax: 937-425-4146
Mailing address:
  • Phone: 937-499-8273
  • Fax: 937-223-9811

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberCOA.18678-NP
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN.349333
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: