Provider Demographics
NPI:1760878185
Name:CHRISTOFIDIS, NICHOLAS (APRN, FNP-C)
Entity Type:Individual
Prefix:
First Name:NICHOLAS
Middle Name:
Last Name:CHRISTOFIDIS
Suffix:
Gender:M
Credentials:APRN, FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25495 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:ARDMORE
Mailing Address - State:TN
Mailing Address - Zip Code:38449-3155
Mailing Address - Country:US
Mailing Address - Phone:931-427-6969
Mailing Address - Fax:931-427-6967
Practice Address - Street 1:25495 MAIN ST
Practice Address - Street 2:
Practice Address - City:ARDMORE
Practice Address - State:TN
Practice Address - Zip Code:38449-3155
Practice Address - Country:US
Practice Address - Phone:931-427-6969
Practice Address - Fax:931-427-6967
Is Sole Proprietor?:Yes
Enumeration Date:2015-04-13
Last Update Date:2015-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNAPN 19810363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily