Provider Demographics
NPI:1568947133
Name:CRISTIANO, META JEAN (FNP-C)
Entity Type:Individual
Prefix:
First Name:META JEAN
Middle Name:
Last Name:CRISTIANO
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:META JEAN
Other - Middle Name:
Other - Last Name:RUCKSTUHL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:4196 ASHBOURNE CT NE
Mailing Address - Street 2:
Mailing Address - City:ROSWELL
Mailing Address - State:GA
Mailing Address - Zip Code:30075-1981
Mailing Address - Country:US
Mailing Address - Phone:404-441-7773
Mailing Address - Fax:
Practice Address - Street 1:687 JOHNSON FERRY RD
Practice Address - Street 2:
Practice Address - City:MARIETTA
Practice Address - State:GA
Practice Address - Zip Code:30068-4628
Practice Address - Country:US
Practice Address - Phone:770-977-9242
Practice Address - Fax:770-977-9221
Is Sole Proprietor?:No
Enumeration Date:2018-09-30
Last Update Date:2018-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN203422363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily