MEDICARE: CHRISTIE LYNN ASTOR CNP

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	163W00000X	Registered Nurse	RN.349333	OH
2	363LF0000X	Family Nurse Practitioner	COA.18678-NP	OH

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	RN.349333	OTHER	OH	STATE LICENSE
2	APRN.CNP.18678	OTHER	OH	STATE LICENSE

General Provider Information

NPI Number	:	1154788867
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHRISTIE LYNN ASTOR CNP

Provider Business Mailing Address
First Line	:	136 S LUDLOW ST
Second Line	:
City	:	DAYTON
State	:	OH
Zip	:	45402-1813
Country	:	US
Telephone Number	:	937-499-8273
Fax Number	:	937-223-9811

Provider Business Practice Location Address
First Line	:	7700 WASHINGTON VILLAGE DR STE 120
Second Line	:
City	:	CENTERVILLE
State	:	OH
Zip	:	45459-4071
Country	:	US
Telephone Number	:	937-425-4144
Fax Number	:	937-425-4146

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

Provider Enumeration Date	:	01/26/2016
Last Update Date	:	02/27/2025

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