Provider Demographics
NPI:1659975910
Name:DERAMO, CHRISTOPHER CARMEN II (DNP, FNP)
Entity Type:Individual
Prefix:DR
First Name:CHRISTOPHER
Middle Name:CARMEN
Last Name:DERAMO
Suffix:II
Gender:M
Credentials:DNP, FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:112 BRIARWOOD ST
Mailing Address - Street 2:
Mailing Address - City:LYNCHBURG
Mailing Address - State:VA
Mailing Address - Zip Code:24503-2002
Mailing Address - Country:US
Mailing Address - Phone:941-662-7871
Mailing Address - Fax:
Practice Address - Street 1:115 AMBRIAR PLZ
Practice Address - Street 2:
Practice Address - City:AMHERST
Practice Address - State:VA
Practice Address - Zip Code:24521-4741
Practice Address - Country:US
Practice Address - Phone:434-946-9565
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-11-27
Last Update Date:2020-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0024180386363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty