Individual
DIMITRA CHRISTOFORATOS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
SP008184
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
003706
PRESCRIPTION AUTH
PA
01
—
RN526518L
RN LICENSE
PA
01
—
SP008184
CRNP LICENSE
PA
Enumeration date
05/14/2007
Last updated
11/10/2014
Update your record
If you believe information in your NPPES record is inaccurate, or if you wish to update or deactivate your NPI, you can do so directly with CMS at https://nppes.cms.hhs.gov.
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