Provider Demographics
NPI:1437449766
Name:MOUNTAIN, CHRISTINA LEE (DO)
Entity Type:Individual
Prefix:DR
First Name:CHRISTINA
Middle Name:LEE
Last Name:MOUNTAIN
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:CHRISTINA
Other - Middle Name:LEE
Other - Last Name:HARNER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DO
Mailing Address - Street 1:501 GREAT CIRCLE RD
Mailing Address - Street 2:STE. 200
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37228-1317
Mailing Address - Country:US
Mailing Address - Phone:615-222-7685
Mailing Address - Fax:615-222-7237
Practice Address - Street 1:5002 CROSSINGS CIR
Practice Address - Street 2:# 180
Practice Address - City:MOUNT JULIET
Practice Address - State:TN
Practice Address - Zip Code:37122-8471
Practice Address - Country:US
Practice Address - Phone:615-515-9111
Practice Address - Fax:615-758-3791
Is Sole Proprietor?:No
Enumeration Date:2011-04-07
Last Update Date:2016-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
VA0102203650207Q00000X
TNDO0000002939207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN6064343OtherBCBST
TNQ020395Medicaid
TNP01637851OtherRR MEDICARE
TN10308I4481Medicare PIN