Provider Demographics
NPI:1578298303
Name:ANDERSON, CHRISTINA (APRN)
Entity Type:Individual
Prefix:
First Name:CHRISTINA
Middle Name:
Last Name:ANDERSON
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:551 BUCKFIELD RD
Mailing Address - Street 2:
Mailing Address - City:PIKEVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:41501-6806
Mailing Address - Country:US
Mailing Address - Phone:606-253-0713
Mailing Address - Fax:
Practice Address - Street 1:23 WILLOW DR
Practice Address - Street 2:
Practice Address - City:AUXIER
Practice Address - State:KY
Practice Address - Zip Code:41602-9259
Practice Address - Country:US
Practice Address - Phone:606-886-8997
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-07-16
Last Update Date:2024-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY3017405363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily