Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208100000X | Physical Medicine & Rehabilitation Doctor | 12383 | TN |
NPI | 1023390374 |
---|---|
Provider Name | Dr. Christine Nicole Fain |
First Address | Palmyra, TN 37142-2210 |
Second Address | Palmyra, TN 37142-2210 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/09/2011 |
Last Update Date | 27/08/2019 |