Provider Demographics
NPI:1679298897
Name:REARDON, CHRISTINA MICHELLE (RN, PMHNP)
Entity type:Individual
Prefix:
First Name:CHRISTINA
Middle Name:MICHELLE
Last Name:REARDON
Suffix:
Gender:F
Credentials:RN, PMHNP
Other - Prefix:
Other - First Name:CHRISTINA
Other - Middle Name:MICHELLE
Other - Last Name:HUFF
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:2850 S GAYLORD ST
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80210-6020
Mailing Address - Country:US
Mailing Address - Phone:480-636-9435
Mailing Address - Fax:
Practice Address - Street 1:2850 S GAYLORD ST
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80210-6020
Practice Address - Country:US
Practice Address - Phone:480-636-9435
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-10-10
Last Update Date:2022-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO0997803363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health