Provider Demographics
NPI:1598419988
Name:MCILWRATH, CHRISTINA R (DNP, MSN, RN)
Entity type:Individual
Prefix:
First Name:CHRISTINA
Middle Name:R
Last Name:MCILWRATH
Suffix:
Gender:F
Credentials:DNP, MSN, RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2115 RIVERVIEW RD
Mailing Address - Street 2:
Mailing Address - City:ESSEX
Mailing Address - State:MD
Mailing Address - Zip Code:21221-6519
Mailing Address - Country:US
Mailing Address - Phone:410-241-3801
Mailing Address - Fax:
Practice Address - Street 1:2115 RIVERVIEW RD
Practice Address - Street 2:
Practice Address - City:ESSEX
Practice Address - State:MD
Practice Address - Zip Code:21221-6519
Practice Address - Country:US
Practice Address - Phone:410-241-3801
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-02-05
Last Update Date:2024-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR230179363LG0600X, 363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology