Basic Information
| Provider Information | |||||||||
| NPI: | 1841644713 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | CRONK | ||||||||
| FirstName: | CHRISTINA | ||||||||
| MiddleName: | OLSON | ||||||||
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| Mailing Information | |||||||||
| Address1: | PROSPECT HILL COMMUNITY HEALTH CENTER | ||||||||
| Address2: | 322 MAIN ST | ||||||||
| City: | PROSPECT HILL | ||||||||
| State: | NC | ||||||||
| PostalCode: | 273140001 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3365623311 | ||||||||
| FaxNumber: | 3365624444 | ||||||||
| Practice Location | |||||||||
| Address1: | PROSPECT HILL COMMUNITY HEALTH CENTER | ||||||||
| Address2: | 322 MAIN ST | ||||||||
| City: | PROSPECT HILL | ||||||||
| State: | NC | ||||||||
| PostalCode: | 273140001 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3365623311 | ||||||||
| FaxNumber: | 3365624444 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/18/2016 | ||||||||
| LastUpdateDate: | 07/30/2019 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | 2019-00338 | NC | N | Allopathic & Osteopathic Physicians | Family Medicine | 207Q00000X | 218500 | NC | Y | Allopathic & Osteopathic Physicians | Family Medicine |
No ID Information.