Basic Information
| Provider Information | |||||||||
| NPI: | 1376934240 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | NIGHTINGALE | ||||||||
| FirstName: | CHRISTINE | ||||||||
| MiddleName: | MATTHEWS | ||||||||
| NamePrefix: | MRS. | ||||||||
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| Credential: | MSN, FNP-BC, RN | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2700 WESTCHESTER AVE | ||||||||
| Address2: | |||||||||
| City: | PURCHASE | ||||||||
| State: | NY | ||||||||
| PostalCode: | 105772547 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9146075730 | ||||||||
| FaxNumber: | 9144571195 | ||||||||
| Practice Location | |||||||||
| Address1: | 73 MARKET ST | ||||||||
| Address2: | |||||||||
| City: | YONKERS | ||||||||
| State: | NY | ||||||||
| PostalCode: | 107107616 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9148314160 | ||||||||
| FaxNumber: | 9148314161 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/12/2015 | ||||||||
| LastUpdateDate: | 11/26/2018 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LF0000X | 339416 | NY | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Family |
ID Information
| ID | Type | State | Issuer | Description | 04980907 | 05 | NY | MEDICAID |