Provider Demographics
NPI:1871796136
Name:HOUSE, CHRISTINE Y (CNM,MSN)
Entity type:Individual
Prefix:MRS
First Name:CHRISTINE
Middle Name:Y
Last Name:HOUSE
Suffix:
Gender:F
Credentials:CNM,MSN
Other - Prefix:MRS
Other - First Name:CHRISTINE
Other - Middle Name:Y
Other - Last Name:ADAMS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:CNM, MSN
Mailing Address - Street 1:110 W GROVER ST
Mailing Address - Street 2:
Mailing Address - City:SHELBY
Mailing Address - State:NC
Mailing Address - Zip Code:28150-3825
Mailing Address - Country:US
Mailing Address - Phone:704-487-5259
Mailing Address - Fax:704-487-0186
Practice Address - Street 1:110 W GROVER ST
Practice Address - Street 2:
Practice Address - City:SHELBY
Practice Address - State:NC
Practice Address - Zip Code:28150-3825
Practice Address - Country:US
Practice Address - Phone:704-487-5259
Practice Address - Fax:704-487-0186
Is Sole Proprietor?:No
Enumeration Date:2007-06-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC300163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
NCRN#68914TLOtherRN LICE
NC300OtherNC LIC