Provider Demographics
NPI:1164650156
Name:ANSTEAD, CHRISTY MICHELLE (ARNP)
Entity Type:Individual
Prefix:
First Name:CHRISTY
Middle Name:MICHELLE
Last Name:ANSTEAD
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 100005
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30384-0005
Mailing Address - Country:US
Mailing Address - Phone:352-265-5461
Mailing Address - Fax:352-265-5413
Practice Address - Street 1:1600 SW ARCHER RD
Practice Address - Street 2:
Practice Address - City:GAINESVILLE
Practice Address - State:FL
Practice Address - Zip Code:32610-3003
Practice Address - Country:US
Practice Address - Phone:352-265-5461
Practice Address - Fax:352-265-5413
Is Sole Proprietor?:No
Enumeration Date:2009-06-29
Last Update Date:2012-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP9220285363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLCE919XMedicare PIN
FLCE919WMedicare PIN