Provider Demographics
NPI:1184297053
Name:VAN ALLEN, CHRISTINA ASHLEY (APRN, AGACNP-BC)
Entity type:Individual
Prefix:
First Name:CHRISTINA
Middle Name:ASHLEY
Last Name:VAN ALLEN
Suffix:
Gender:F
Credentials:APRN, AGACNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12650 W 64TH AVE # UE501
Mailing Address - Street 2:
Mailing Address - City:ARVADA
Mailing Address - State:CO
Mailing Address - Zip Code:80004-3893
Mailing Address - Country:US
Mailing Address - Phone:204-314-1277
Mailing Address - Fax:
Practice Address - Street 1:12650 W 64TH AVE UNIT E501
Practice Address - Street 2:
Practice Address - City:ARVADA
Practice Address - State:CO
Practice Address - Zip Code:80004-3893
Practice Address - Country:US
Practice Address - Phone:303-431-4127
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-07-20
Last Update Date:2024-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COAPN.0996704363L00000X
COAPN.0996704-NP363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner