CHRISTINA CONNELLY (NPI# 1750739702) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1750739702 |
| Entity Type | Individual |
| Full Name | CHRISTINA CONNELLY |
| Credential | FNP-C |
| Practice Address |
2640 Hamstrom Rd Portage IN 46368-3832 |
| Practice Telephone | 2197624423 |
| Mailing Telephone | 2197624423 |
| Enumeration Date | 2016-06-01 |
| Last Update Date | 2017-11-03 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
71006279A | IN | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IN | APN | 71006279A | 01 |
| IN | CSR | 71006279B | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528315637 | Christina Ann Connelly | Chiropractor | 98 Whiting St Unit C, Plainville, CT 06062-2881 | 2012-08-08 |
| 1063763878 | Christina Connelly | Licensed Practical Nurse | 265 N Michigan Ave, Coldwater, MI 49036-1528 | 2012-09-20 |
| 1427030345 | Christina Connelly | Nurse Practitioner | 477 Andover St, North Andover, MA 01845-5036 | 2005-11-16 |
| Street Address |
2640 HAMSTROM RD |
| City | PORTAGE |
| State | IN |
| Zip Code | 46368-3832 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386646529 | Shreyas Arvind Desai | Family Medicine | 2640 Hamstrom Rd, Portage, IN 46368-3832 | 2005-06-01 |
| 1750738423 | Christine A Sackenheim | Nurse Practitioner | 2640 Hamstrom Rd, Portage, IN 46368-3832 | 2016-05-23 |
| 1114315041 | New Beginnings Suboxone Treatment, LLC Corp | Internal Medicine | 2640 Hamstrom Rd, Portage, IN 46368-3832 | 2014-12-30 |
| 1861799090 | Gayle Marie Voight-block | Nurse Practitioner | 2640 Hamstrom Rd, Portage, IN 46368-2460 | 2011-02-24 |
| 1992934020 | Havishakrishna Sarma | Internal Medicine | 2640 Hamstrom Rd, Portage, IN 46368-3832 | 2009-07-10 |
| 1891980462 | Faizuddin Shareef | Family Medicine | 2640 Hamstrom Rd, Portage, IN 46368-3832 | 2007-09-07 |
| 1407965320 | Kathryn Mary Wallace | Nurse Practitioner | 2640 Hamstrom Rd, Portage, IN 46368-3832 | 2006-08-30 |
| 1417983537 | Internal Medicine,geriatrics and Oncology Group, P.C. | Internal Medicine | 2640 Hamstrom Rd, Portage, IN 46368-3832 | 2006-06-23 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366041121 | Latresa Renee Sims | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 1777 Armstrong St. Suite C., Portage, IN 46368 | 2020-10-22 |
| 1831576693 | Bishara Robert Khoury | Family Medicine | 3545 Arbor Blvd Ste E, Portage, IN 46368 | 2015-04-30 |
| 1962813535 | Diane Farrington | Pharmacist | 6050 Us Hwy 6, Portage, IN 46368 | 2014-05-16 |
| 1588827562 | Jennifer Ann Rumpel | Allergy & Immunology | 6375 Us Highway 6 Ste C, Portage, IN 46368 | 2008-07-09 |
| 1588822688 | Total Renal Care Inc | Clinic/Center | 5823 Us Highway 6, Portage, IN 46368 | 2008-05-27 |
| 1235321480 | Michael Wendahl | Physical Therapist | 3691 Willowcreek Road, Suite 100, Portage, IN 46368 | 2007-08-13 |
| 1679663603 | Stephen V Headley | Family Medicine | 3283 Willowcreek Rd, Portage, IN 46368 | 2006-10-13 |
| 1730276486 | Robert Tan Ang | Psychiatry & Neurology | 3156 Willowcreek Road, Portage, IN 46368 | 2006-10-06 |
| 1013029883 | Primary Care PC | Family Medicine | 3125 Willowcreek Road, Portage, IN 46368 | 2006-08-31 |
| 1104936962 | Margaret Eileen Griffith | Dentist | 2646 Lois Street, Portage, IN 46368 | 2006-08-30 |
| Find all providers in zip 46368 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063031367 | Patricia Evelyn Biel | Nurse Practitioner | 5511 Redwood Avenue, Portage, IN 46368-4302 | 2020-04-16 |
| 1366092975 | Rachel Jaynu Nimely-scott | Nurse Practitioner | 5722 Kingman Ave, Portage, IN 46368-1529 | 2019-09-16 |
| 1174082523 | Upstream Health and Wellness, LLC | Nurse Practitioner | 3200 Willowcreek Rd Ste B, Portage, IN 46368-4486 | 2019-03-15 |
| 1972087161 | Danielle R Geroski | Nurse Practitioner | 9900 Huffman Rd, Portage, OH 43451-9739 | 2018-09-24 |
| 1780927889 | Marianne Harman | Nurse Practitioner | 6652 Lakewood Ave, Chhabra Medical Corporation PC, Portage, IN 46368-2404 | 2013-03-27 |
| 1164640884 | Barbara Jane Heric | Nurse Practitioner | 6615 S Boundary Rd, Portage, IN 46368-1373 | 2007-04-20 |
| 1063562585 | Manjerngie Cecelia Ndebe | Nurse Practitioner | 451 W. Milham Ave, Portage, MI 49024 | 2007-01-10 |
| 1982204640 | Kaitlyn Renea Davidson | Nurse Practitioner | 3304 Cooley Ct, Portage, MI 49024-7430 | 2020-10-30 |
| 1467052753 | Courtney Brooke Wyant | Nurse Practitioner | 3304 Cooley Ct, Portage, MI 49024-7430 | 2020-10-27 |
| 1114551777 | Kelsey Lankford | Nurse Practitioner | 7901 Angling Rd, Portage, MI 49024-0714 | 2020-02-23 |
| Find all providers in PORTAGE | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.