Provider Demographics
NPI:1699145789
Name:MANN, CHRISTA M (APRN, FNP-C)
Entity type:Individual
Prefix:MS
First Name:CHRISTA
Middle Name:M
Last Name:MANN
Suffix:
Gender:F
Credentials:APRN, FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:270 AMITY RD STE 132
Mailing Address - Street 2:
Mailing Address - City:WOODBRIDGE
Mailing Address - State:CT
Mailing Address - Zip Code:06525-2236
Mailing Address - Country:US
Mailing Address - Phone:203-318-6143
Mailing Address - Fax:475-271-8574
Practice Address - Street 1:270 AMITY RD STE 132
Practice Address - Street 2:
Practice Address - City:WOODBRIDGE
Practice Address - State:CT
Practice Address - Zip Code:06525-2236
Practice Address - Country:US
Practice Address - Phone:033-186-1432
Practice Address - Fax:475-271-8574
Is Sole Proprietor?:Yes
Enumeration Date:2015-10-01
Last Update Date:2024-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT6296363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily