1538735113 NPI number — CHRISTINE ANN BOONE PMHNP-BC

Table of content: CHRISTINE ANN BOONE PMHNP-BC (NPI 1538735113)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1538735113 NPI number — CHRISTINE ANN BOONE PMHNP-BC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
BOONE
Provider First Name:
CHRISTINE
Provider Middle Name:
ANN
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
PMHNP-BC
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1538735113
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
10/08/2025
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
NAVAL MEDICAL CENTER
Provider Second Line Business Mailing Address:
100 BREWSTER BLVD.
Provider Business Mailing Address City Name:
CAMP LEJEUNE
Provider Business Mailing Address State Name:
NC
Provider Business Mailing Address Postal Code:
28547-2538
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
910-450-4700
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
MARINE CORPS BASE CAMP LEJEUNE, H STREET
Provider Second Line Business Practice Location Address:
BUILDING 326, OFFICE 247
Provider Business Practice Location Address City Name:
CAMP LEJEUNE
Provider Business Practice Location Address State Name:
NC
Provider Business Practice Location Address Postal Code:
28542
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
910-451-9226
Provider Business Practice Location Address Fax Number:
580-200-0796
Provider Enumeration Date:
06/03/2021

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 363LP0808X , with the licence number:  ANCC2021027031 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 363LP0808X , with the licence number: 65316 , registered in the state of NM ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 96102987 . This is a "AMERICAN NURSES CREDENTIALING CENTER CONFIRMATION #" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".




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