Provider Demographics
NPI:1194378554
Name:STRAESSLE, CHRISTINE LOUISE (BC)
Entity Type:Individual
Prefix:
First Name:CHRISTINE
Middle Name:LOUISE
Last Name:STRAESSLE
Suffix:
Gender:F
Credentials:BC
Other - Prefix:
Other - First Name:CHRISTINE
Other - Middle Name:
Other - Last Name:MEDINA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:271 CAMPINAS ST
Mailing Address - Street 2:
Mailing Address - City:PUNTA GORDA
Mailing Address - State:FL
Mailing Address - Zip Code:33983-5567
Mailing Address - Country:US
Mailing Address - Phone:845-476-9589
Mailing Address - Fax:
Practice Address - Street 1:329 E OLYMPIA AVE
Practice Address - Street 2:
Practice Address - City:PUNTA GORDA
Practice Address - State:FL
Practice Address - Zip Code:33950-3833
Practice Address - Country:US
Practice Address - Phone:239-561-3376
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-07-24
Last Update Date:2023-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF344748-01363LF0000X
FL11019461363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily