Provider Demographics
NPI:1336132091
Name:HARTIGAN, CHRISTOPHER JAMES (RN,BC,FNP)
Entity Type:Individual
Prefix:MR
First Name:CHRISTOPHER
Middle Name:JAMES
Last Name:HARTIGAN
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Gender:M
Credentials:RN,BC,FNP
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Mailing Address - Street 1:1001 W WORLEY ST
Mailing Address - Street 2:FAMILY HEALTH CENTER OF BOONE COUNTY
Mailing Address - City:COLUMBIA
Mailing Address - State:MO
Mailing Address - Zip Code:65203-2037
Mailing Address - Country:US
Mailing Address - Phone:573-214-2314
Mailing Address - Fax:573-814-2784
Practice Address - Street 1:1001 W WORLEY ST
Practice Address - Street 2:FAMILY HEALTH CENTER OF BOONE COUNTY
Practice Address - City:COLUMBIA
Practice Address - State:MO
Practice Address - Zip Code:65203-2037
Practice Address - Country:US
Practice Address - Phone:573-214-2314
Practice Address - Fax:573-814-2784
Is Sole Proprietor?:No
Enumeration Date:2005-08-29
Last Update Date:2020-03-04
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Provider Licenses
StateLicense IDTaxonomies
MO124699363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO428658124Medicaid
P76532Medicare UPIN
MO829702399Medicare ID - Type Unspecified