Provider Demographics
NPI:1750839205
Name:TANCRETO, CHRISTINA (ARNP)
Entity Type:Individual
Prefix:
First Name:CHRISTINA
Middle Name:
Last Name:TANCRETO
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6817 SOUTHPOINT PKWY STE 102
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32216-6285
Mailing Address - Country:US
Mailing Address - Phone:904-513-3998
Mailing Address - Fax:904-575-4919
Practice Address - Street 1:6817 SOUTHPOINT PKWY STE 102
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32216-6285
Practice Address - Country:US
Practice Address - Phone:904-513-3998
Practice Address - Fax:904-575-4919
Is Sole Proprietor?:No
Enumeration Date:2016-09-13
Last Update Date:2024-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN9320061363LF0000X
FLARNP9320061363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily