Provider Demographics
NPI:1053789578
Name:HUMPHRIES, CHRISTINE (APRN)
Entity type:Individual
Prefix:
First Name:CHRISTINE
Middle Name:
Last Name:HUMPHRIES
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:CHRISTINE
Other - Middle Name:
Other - Last Name:WORKMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:608 CHEAT RD
Mailing Address - Street 2:
Mailing Address - City:MORGANTOWN
Mailing Address - State:WV
Mailing Address - Zip Code:26508-4210
Mailing Address - Country:US
Mailing Address - Phone:304-594-1313
Mailing Address - Fax:
Practice Address - Street 1:608 CHEAT RD
Practice Address - Street 2:
Practice Address - City:MORGANTOWN
Practice Address - State:WV
Practice Address - Zip Code:26508-4210
Practice Address - Country:US
Practice Address - Phone:304-594-1313
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-09-15
Last Update Date:2015-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV75259363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily