Christine D Medina

Individual provider Active NPI Licensed Practical Nurse · Prattsburgh, NY

NPI 1932059987 · NPPES record last updated Jan 30, 2026

Key facts

NPI
1932059987
Entity type
Individual (NPI type 1)
Primary specialty
Licensed Practical Nurse 164W00000X
License
290275 (NY)
Practice address
10318 Mattoon Rd
Prattsburgh, NY 14873-9335
Phone
(607) 794-1743
NPI assigned
Jan 30, 2026
Sex
Female
Sole proprietor
Yes

Medicare participation

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

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
290275NYMDLicensed Practical Nurse

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X 290275 NY Yes

Addresses

Primary practice location

10318 Mattoon Rd
Prattsburgh, NY 14873-9335

Mailing address

10318 Mattoon Rd
Prattsburgh, NY 14873-9335
Phone (607) 794-1743

Other providers in Prattsburgh, NY

All providers in Prattsburgh, NY · Licensed Practical Nurse in New York

Sources for this page

Verify at the official NPI Registry.