Provider Demographics
NPI:1215979364
Name:TOBIN, CHRISTINE KAY (FNP-LPA)
Entity type:Individual
Prefix:
First Name:CHRISTINE
Middle Name:KAY
Last Name:TOBIN
Suffix:
Gender:F
Credentials:FNP-LPA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:505 N HIGHWAY 77
Mailing Address - Street 2:SUITE 200
Mailing Address - City:WAXAHACHIE
Mailing Address - State:TX
Mailing Address - Zip Code:75165-1128
Mailing Address - Country:US
Mailing Address - Phone:972-923-1686
Mailing Address - Fax:972-937-7731
Practice Address - Street 1:505 N HIGHWAY 77
Practice Address - Street 2:SUITE 200
Practice Address - City:WAXAHACHIE
Practice Address - State:TX
Practice Address - Zip Code:75165-1128
Practice Address - Country:US
Practice Address - Phone:972-923-1686
Practice Address - Fax:972-937-7731
Is Sole Proprietor?:No
Enumeration Date:2006-06-12
Last Update Date:2013-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX447076363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK100015600AMedicaid
TX121192209Medicaid
TX121192207Medicaid
OK100015600AMedicaid
TXP01161795Medicare PIN
TXP00342914Medicare PIN
TXG4627Medicare PIN
TXR95751Medicare UPIN
TX121192209Medicaid