Provider Demographics
NPI:1386288710
Name:THOMAS, CHRISTINA (CRNP)
Entity type:Individual
Prefix:
First Name:CHRISTINA
Middle Name:
Last Name:THOMAS
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7301 WEST BLVD STE A1
Mailing Address - Street 2:
Mailing Address - City:BOARDMAN
Mailing Address - State:OH
Mailing Address - Zip Code:44512-5268
Mailing Address - Country:US
Mailing Address - Phone:330-758-2775
Mailing Address - Fax:330-758-2787
Practice Address - Street 1:3548 ELLWOOD RD
Practice Address - Street 2:
Practice Address - City:NEW CASTLE
Practice Address - State:PA
Practice Address - Zip Code:16101-6122
Practice Address - Country:US
Practice Address - Phone:724-658-9477
Practice Address - Fax:724-658-9476
Is Sole Proprietor?:No
Enumeration Date:2019-10-29
Last Update Date:2019-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP020672207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine