Provider Demographics
NPI:1861426215
Name:ATKINS, CHRISTINE (FNP)
Entity type:Individual
Prefix:
First Name:CHRISTINE
Middle Name:
Last Name:ATKINS
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20 CANALVIEW MALL
Mailing Address - Street 2:
Mailing Address - City:FULTON
Mailing Address - State:NY
Mailing Address - Zip Code:13069-1735
Mailing Address - Country:US
Mailing Address - Phone:315-598-1237
Mailing Address - Fax:315-410-1388
Practice Address - Street 1:20 CANALVIEW MALL
Practice Address - Street 2:
Practice Address - City:FULTON
Practice Address - State:NY
Practice Address - Zip Code:13069-1735
Practice Address - Country:US
Practice Address - Phone:315-598-1237
Practice Address - Fax:315-410-1388
Is Sole Proprietor?:No
Enumeration Date:2006-07-10
Last Update Date:2018-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF330674363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02184861Medicaid
NYJ400037297Medicare PIN
NY02184861Medicaid
S89758Medicare UPIN