Provider Demographics
NPI:1578834131
Name:SHOOTER, CHRISTINE (FNP)
Entity Type:Individual
Prefix:
First Name:CHRISTINE
Middle Name:
Last Name:SHOOTER
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:CHRISTINE
Other - Middle Name:
Other - Last Name:SHOOTER
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:FNP
Mailing Address - Street 1:101 MANNING DR
Mailing Address - Street 2:CB# 7025
Mailing Address - City:CHAPEL HILL
Mailing Address - State:NC
Mailing Address - Zip Code:27514-4220
Mailing Address - Country:US
Mailing Address - Phone:919-966-4401
Mailing Address - Fax:919-966-6501
Practice Address - Street 1:101 MANNING DR
Practice Address - Street 2:CB# 7025
Practice Address - City:CHAPEL HILL
Practice Address - State:NC
Practice Address - Zip Code:27514-4220
Practice Address - Country:US
Practice Address - Phone:919-966-4401
Practice Address - Fax:919-966-6501
Is Sole Proprietor?:No
Enumeration Date:2012-01-13
Last Update Date:2012-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC5001616363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily