Provider Demographics
NPI:1558062000
Name:LUNDBERG, CHRISTIAN PAIGE (FNP)
Entity Type:Individual
Prefix:
First Name:CHRISTIAN
Middle Name:PAIGE
Last Name:LUNDBERG
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:284 BREAKERS BEND DR
Mailing Address - Street 2:
Mailing Address - City:BUCHANAN
Mailing Address - State:TN
Mailing Address - Zip Code:38222-4990
Mailing Address - Country:US
Mailing Address - Phone:615-686-8846
Mailing Address - Fax:
Practice Address - Street 1:243 JIM ADAMS DR
Practice Address - Street 2:
Practice Address - City:PARIS
Practice Address - State:TN
Practice Address - Zip Code:38242-4967
Practice Address - Country:US
Practice Address - Phone:731-644-2747
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-03-13
Last Update Date:2023-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN33583363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily