Individual provider Active NPI

Christina Irene Prince, MSN, RN, FNP-BC

  • Family Nurse Practitioner
  • Macon, GA
National Provider Identifier
1124677893
Registry record updated Jun 3, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
RN293292 Issued in GA
Practice address
1544 Bass Rd
Macon, GA 31210-7510
Phone
(478) 471-4494
NPI assigned
Sep 5, 2019
Last updated
Jun 3, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 3, 2021

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 6

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 187027 TN
Medical-Surgical Registered Nurse 163WM0705X 187027 TN
Nurse Practitioner 363L00000X 93502 TN
Nurse Practitioner 363L00000X RN293292 GA
Family Nurse Practitioner 363LF0000X 93502 TN
Family Nurse Practitioner 363LF0000X RN293292 GA Primary

Addresses

Primary practice location

1544 Bass Rd
Macon, GA 31210-7510

Mailing address

PO Box 1894
Perry, GA 31069-1894
Phone (615) 522-8421

Other identifiers 1

IdentifierTypeStateIssuer
RN293292OtherGAADVANCED PRACTICE REGISTERED NURSE - NP

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science - Nursing, Registered Nurse

State licenses

LicenseStateTypeSpecialty
187027TNMDMedical-Surgical Registered Nurse
RN293292GAMDFamily Nurse Practitioner
93502TNMDFamily Nurse Practitioner

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1567641600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1622678400000",
    "number": "1124677893",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1894",
            "city": "PERRY",
            "state": "GA",
            "postal_code": "310691894",
            "telephone_number": "615-522-8421"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1544 BASS RD",
            "city": "MACON",
            "state": "GA",
            "postal_code": "312107510",
            "telephone_number": "478-471-4494"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PRINCE",
        "first_name": "CHRISTINA",
        "middle_name": "IRENE",
        "credential": "MSN, RN, FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-09-05",
        "last_updated": "2021-06-03",
        "certification_date": "2020-12-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "TN",
            "license": "187027",
            "primary": false
        },
        {
            "code": "163WM0705X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Medical-Surgical",
            "state": "TN",
            "license": "187027",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "TN",
            "license": "93502",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "GA",
            "license": "RN293292",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TN",
            "license": "93502",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "RN293292",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ADVANCED PRACTICE REGISTERED NURSE - NP",
            "identifier": "RN293292",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Macon, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 3, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.