Provider Demographics
NPI:1558625715
Name:HACKNEY, CHRISTA NICOLE (FPMHNP-BC)
Entity type:Individual
Prefix:DR
First Name:CHRISTA
Middle Name:NICOLE
Last Name:HACKNEY
Suffix:
Gender:F
Credentials:FPMHNP-BC
Other - Prefix:
Other - First Name:CHRISTA
Other - Middle Name:NICOLE
Other - Last Name:ADAMS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS, RN
Mailing Address - Street 1:14 STEBBINS ST
Mailing Address - Street 2:
Mailing Address - City:SAINT ALBANS
Mailing Address - State:VT
Mailing Address - Zip Code:05478-2462
Mailing Address - Country:US
Mailing Address - Phone:802-427-4144
Mailing Address - Fax:802-555-7992
Practice Address - Street 1:14 STEBBINS ST
Practice Address - Street 2:
Practice Address - City:SAINT ALBANS
Practice Address - State:VT
Practice Address - Zip Code:05478-2462
Practice Address - Country:US
Practice Address - Phone:802-427-4144
Practice Address - Fax:802-555-7992
Is Sole Proprietor?:Yes
Enumeration Date:2012-07-02
Last Update Date:2022-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT101.0088814363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health