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General NPI Number Information
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NPI Number | 1639827744
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Entity Type | Individual
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Provider Name | CRISTINA MARIA CHENOWETH NP-C
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Gender | Female
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Dates
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Enumeration Date | 03/17/2022
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Last Update Date | 10/23/2024
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Provider Practice Location Address
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Address Line | 4506 1ST AVE
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City | EVANSVILLE
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State | IN
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Zip | 47710-3624
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Country | US
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Telephone | 812-428-6161
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Fax |
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Provider Business Mailing Address
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Address Line | 4506 1ST AVE
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City | EVANSVILLE
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State | IN
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Zip | 47710-3624
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Country | US
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Telephone | 812-450-6815
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Fax | 812-450-6822
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 3017390
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License Number State | KY
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Taxonomy #2
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 71012452A
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License Number State | IN
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