Provider Demographics
NPI:1578068235
Name:TITLE, CHRISTOPHER E (FNP-BC)
Entity Type:Individual
Prefix:MR
First Name:CHRISTOPHER
Middle Name:E
Last Name:TITLE
Suffix:
Gender:M
Credentials:FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6200 PINE HOLLOW DR STE 400
Mailing Address - Street 2:
Mailing Address - City:EAST LANSING
Mailing Address - State:MI
Mailing Address - Zip Code:48823-9224
Mailing Address - Country:US
Mailing Address - Phone:517-339-1676
Mailing Address - Fax:517-339-2716
Practice Address - Street 1:6200 PINE HOLLOW DR STE 400
Practice Address - Street 2:
Practice Address - City:EAST LANSING
Practice Address - State:MI
Practice Address - Zip Code:48823-9224
Practice Address - Country:US
Practice Address - Phone:517-339-1676
Practice Address - Fax:517-339-2716
Is Sole Proprietor?:No
Enumeration Date:2018-03-26
Last Update Date:2018-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704238068363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily