Provider Demographics
NPI:1891198123
Name:WALDRON, CHRISTY (NP-C)
Entity Type:Individual
Prefix:
First Name:CHRISTY
Middle Name:
Last Name:WALDRON
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1071 S SUN DR
Mailing Address - Street 2:SUITE 1043
Mailing Address - City:LAKE MARY
Mailing Address - State:FL
Mailing Address - Zip Code:32746-2573
Mailing Address - Country:US
Mailing Address - Phone:407-302-2620
Mailing Address - Fax:407-302-2690
Practice Address - Street 1:1071 S SUN DR
Practice Address - Street 2:SUITE 1043
Practice Address - City:LAKE MARY
Practice Address - State:FL
Practice Address - Zip Code:32746-2573
Practice Address - Country:US
Practice Address - Phone:407-302-2620
Practice Address - Fax:407-302-2690
Is Sole Proprietor?:No
Enumeration Date:2014-10-01
Last Update Date:2022-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP9179243363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner