Provider Demographics
NPI:1477882454
Name:HARLAN, CHRISTINE MEREDITH (FNP-BC)
Entity Type:Individual
Prefix:MRS
First Name:CHRISTINE
Middle Name:MEREDITH
Last Name:HARLAN
Suffix:
Gender:F
Credentials:FNP-BC
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Mailing Address - Street 1:670 MASON RIDGE CENTER DR
Mailing Address - Street 2:STE 300
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63141-8573
Mailing Address - Country:US
Mailing Address - Phone:618-474-1723
Mailing Address - Fax:618-462-6988
Practice Address - Street 1:2 MEMORIAL DR
Practice Address - Street 2:SUITE 220
Practice Address - City:ALTON
Practice Address - State:IL
Practice Address - Zip Code:62002-6723
Practice Address - Country:US
Practice Address - Phone:618-474-1723
Practice Address - Fax:618-462-6988
Is Sole Proprietor?:No
Enumeration Date:2009-12-21
Last Update Date:2013-01-30
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MO2003018128163W00000X
IL041.381061163W00000X
IL209-008042363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse