Provider Demographics
NPI:1124113774
Name:ZARTLER, CHRISTINE KENYON (RN, MSN, CPNP)
Entity type:Individual
Prefix:MRS
First Name:CHRISTINE
Middle Name:KENYON
Last Name:ZARTLER
Suffix:
Gender:F
Credentials:RN, MSN, CPNP
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Mailing Address - Street 1:502 S. OLD ORCHARD LANE
Mailing Address - Street 2:SUITE 126
Mailing Address - City:LEWISVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:75067-4370
Mailing Address - Country:US
Mailing Address - Phone:972-436-7962
Mailing Address - Fax:972-353-5780
Practice Address - Street 1:502 S. OLD ORCHARD LANE
Practice Address - Street 2:SUITE 126
Practice Address - City:LEWISVILLE
Practice Address - State:TX
Practice Address - Zip Code:75067-4370
Practice Address - Country:US
Practice Address - Phone:972-436-7962
Practice Address - Fax:972-353-5780
Is Sole Proprietor?:No
Enumeration Date:2006-10-03
Last Update Date:2021-12-15
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Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TX563157363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX01733OtherPRESCIPTIVE AUTHORITY
TX1475519-01Medicaid
TX1475519-01Medicaid