Provider Demographics
NPI:1578957122
Name:LUMPKIN, CHRISTINA LYNETTE (AGNP)
Entity Type:Individual
Prefix:
First Name:CHRISTINA
Middle Name:LYNETTE
Last Name:LUMPKIN
Suffix:
Gender:F
Credentials:AGNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8901 LEZLARKEN LN
Mailing Address - Street 2:
Mailing Address - City:OLIVE BRANCH
Mailing Address - State:MS
Mailing Address - Zip Code:38654-6877
Mailing Address - Country:US
Mailing Address - Phone:731-377-4092
Mailing Address - Fax:
Practice Address - Street 1:1430 GRACELAND PINES ST
Practice Address - Street 2:
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38116-5902
Practice Address - Country:US
Practice Address - Phone:901-677-0670
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-03-21
Last Update Date:2024-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN20002363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner