Provider Demographics
NPI:1689215931
Name:CHRISTIAN, MARIE RACHEL (APRN)
Entity Type:Individual
Prefix:
First Name:MARIE
Middle Name:RACHEL
Last Name:CHRISTIAN
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 1:16158 S MILITARY TRL
Mailing Address - Street 2:
Mailing Address - City:DELRAY BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33484-6502
Mailing Address - Country:US
Mailing Address - Phone:561-495-0522
Mailing Address - Fax:561-496-5064
Practice Address - Street 1:14801 64TH CT N
Practice Address - Street 2:
Practice Address - City:LOXAHATCHEE
Practice Address - State:FL
Practice Address - Zip Code:33470-5324
Practice Address - Country:US
Practice Address - Phone:954-483-8752
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-10-07
Last Update Date:2019-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN11004447363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health