Provider Demographics
NPI:1326583642
Name:CHRISTIAN, THERESA DANIELLE (FNP-C)
Entity Type:Individual
Prefix:MS
First Name:THERESA
Middle Name:DANIELLE
Last Name:CHRISTIAN
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7814 BURRO BND
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78244-3520
Mailing Address - Country:US
Mailing Address - Phone:210-421-6188
Mailing Address - Fax:
Practice Address - Street 1:7814 BURRO BND
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78244-3520
Practice Address - Country:US
Practice Address - Phone:210-421-6188
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-12-21
Last Update Date:2016-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP132819363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily