Provider Demographics
NPI:1295017317
Name:JAGGERS, CHRISTY F (FNP)
Entity Type:Individual
Prefix:
First Name:CHRISTY
Middle Name:F
Last Name:JAGGERS
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1542 MEDICAL PARK CIR
Mailing Address - Street 2:
Mailing Address - City:TUPELO
Mailing Address - State:MS
Mailing Address - Zip Code:38801-6560
Mailing Address - Country:US
Mailing Address - Phone:662-256-7112
Mailing Address - Fax:662-256-7116
Practice Address - Street 1:1107 EARL FRYE BLVD
Practice Address - Street 2:SUITE 5
Practice Address - City:AMORY
Practice Address - State:MS
Practice Address - Zip Code:38821-5519
Practice Address - Country:US
Practice Address - Phone:662-257-6705
Practice Address - Fax:662-256-6229
Is Sole Proprietor?:No
Enumeration Date:2011-09-14
Last Update Date:2017-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MSR862068363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics