Provider Demographics
NPI:1538703004
Name:CHRISTIAN, JANICE
Entity Type:Individual
Prefix:
First Name:JANICE
Middle Name:
Last Name:CHRISTIAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5401 PALMER CROSSING CIR
Mailing Address - Street 2:
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34233-3208
Mailing Address - Country:US
Mailing Address - Phone:940-554-2352
Mailing Address - Fax:
Practice Address - Street 1:5401 PALMER CROSSING CIR
Practice Address - Street 2:
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34233-3208
Practice Address - Country:US
Practice Address - Phone:940-554-2352
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-10-29
Last Update Date:2019-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS57206183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist