Provider Demographics
NPI:1295201432
Name:DUFF, CHRISTA GAIL (APRN)
Entity Type:Individual
Prefix:
First Name:CHRISTA
Middle Name:GAIL
Last Name:DUFF
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:538 RIDGEVIEW WAY
Mailing Address - Street 2:
Mailing Address - City:HAZARD
Mailing Address - State:KY
Mailing Address - Zip Code:41701-8924
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:200 MEDICAL CENTER DR
Practice Address - Street 2:
Practice Address - City:HAZARD
Practice Address - State:KY
Practice Address - Zip Code:41701-9466
Practice Address - Country:US
Practice Address - Phone:606-487-7933
Practice Address - Fax:606-487-7931
Is Sole Proprietor?:No
Enumeration Date:2018-10-15
Last Update Date:2019-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY3012777208D00000X, 363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice