Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 363LF0000X | Nurse Practitioner - Family Medicine | 1-043213 | AL |
N | 363LF0000X | Nurse Practitioner - Family Medicine | 2004021312 | MO |
N | 363LF0000X | Nurse Practitioner - Family Medicine | AP4572 | AZ |
N | 363LF0000X | Nurse Practitioner - Family Medicine | APN 0000016560 | TN |
Y | 363LF0000X | Nurse Practitioner - Family Medicine | F336940-1 | NY |
N | 363LF0000X | Nurse Practitioner - Family Medicine | NP21695 | CA |
NPI | 1003119256 |
---|---|
Provider Name | Christine Anne |
First Address | Huntsville, AL 35802-1664 |
Second Address | Gurley, AL 35748-8847 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 09/12/2010 |
Last Update Date | 12/08/2013 |