Provider Demographics
NPI:1598180614
Name:DZIOBA, CHRISTINA L (RN, WHNP-BC, C-EFM)
Entity Type:Individual
Prefix:MS
First Name:CHRISTINA
Middle Name:L
Last Name:DZIOBA
Suffix:
Gender:F
Credentials:RN, WHNP-BC, C-EFM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1505 FORT CLARKE BLVD APT 6108
Mailing Address - Street 2:
Mailing Address - City:GAINESVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32606-9102
Mailing Address - Country:US
Mailing Address - Phone:608-213-3167
Mailing Address - Fax:
Practice Address - Street 1:1505 FORT CLARKE BLVD APT 6108
Practice Address - Street 2:
Practice Address - City:GAINESVILLE
Practice Address - State:FL
Practice Address - Zip Code:32606-9102
Practice Address - Country:US
Practice Address - Phone:608-213-3167
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-02-26
Last Update Date:2015-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI4380-33363LW0102X
FLARNP9404349363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL014675400Medicaid
FLID228ZMedicare PIN