Provider Demographics
NPI:1548291990
Name:KUSHNER, CHRISTINE E (CRNP)
Entity type:Individual
Prefix:MS
First Name:CHRISTINE
Middle Name:E
Last Name:KUSHNER
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 1:3 S BRADY ST STE 205
Mailing Address - Street 2:
Mailing Address - City:DU BOIS
Mailing Address - State:PA
Mailing Address - Zip Code:15801-2159
Mailing Address - Country:US
Mailing Address - Phone:814-371-1088
Mailing Address - Fax:814-371-4966
Practice Address - Street 1:3 S BRADY ST STE 205
Practice Address - Street 2:
Practice Address - City:DU BOIS
Practice Address - State:PA
Practice Address - Zip Code:15801-2159
Practice Address - Country:US
Practice Address - Phone:814-371-1088
Practice Address - Fax:814-371-4966
Is Sole Proprietor?:No
Enumeration Date:2006-07-05
Last Update Date:2020-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARN274879L163WP0808X
PASP021515363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA001635633OtherHIGHMARK