Provider Demographics
NPI:1992901961
Name:COTTON, CHRISTINA MARIE (RN, CPNP)
Entity type:Individual
Prefix:MISS
First Name:CHRISTINA
Middle Name:MARIE
Last Name:COTTON
Suffix:
Gender:F
Credentials:RN, CPNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:404 RIO GRANDE ST
Mailing Address - Street 2:APT 335
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78701-2789
Mailing Address - Country:US
Mailing Address - Phone:512-628-1910
Mailing Address - Fax:512-628-1911
Practice Address - Street 1:1301 BARBARA JORDAN BLVD
Practice Address - Street 2:STE 401
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78723-3077
Practice Address - Country:US
Practice Address - Phone:512-628-1910
Practice Address - Fax:512-628-1911
Is Sole Proprietor?:No
Enumeration Date:2007-06-26
Last Update Date:2019-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX736174363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX204677301Medicaid
TX204677301Medicaid