Provider Demographics
NPI:1174134704
Name:DIPAOLO, CHRISTINA (APN)
Entity type:Individual
Prefix:
First Name:CHRISTINA
Middle Name:
Last Name:DIPAOLO
Suffix:
Gender:F
Credentials:APN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:451 MONROE AVE
Mailing Address - Street 2:
Mailing Address - City:WHITING
Mailing Address - State:NJ
Mailing Address - Zip Code:08759-2439
Mailing Address - Country:US
Mailing Address - Phone:609-299-8561
Mailing Address - Fax:
Practice Address - Street 1:853 MILL CREEK RD
Practice Address - Street 2:
Practice Address - City:MANAHAWKIN
Practice Address - State:NJ
Practice Address - Zip Code:08050-4562
Practice Address - Country:US
Practice Address - Phone:609-374-4178
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-08-17
Last Update Date:2021-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NR15778800163WE0003X
NJ26NJ01070000363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No163WE0003XNursing Service ProvidersRegistered NurseEmergency