Provider Demographics
NPI:1902228174
Name:CHRISTIAN, MINNIE MARIE (CRNP)
Entity Type:Individual
Prefix:
First Name:MINNIE
Middle Name:MARIE
Last Name:CHRISTIAN
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:MINNIE
Other - Middle Name:MARIE
Other - Last Name:CHRISTIAN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:CRNP
Mailing Address - Street 1:5581 PARK SIDE RD
Mailing Address - Street 2:
Mailing Address - City:HOOVER
Mailing Address - State:AL
Mailing Address - Zip Code:35244-5146
Mailing Address - Country:US
Mailing Address - Phone:205-531-6938
Mailing Address - Fax:
Practice Address - Street 1:680 COHASSET RD
Practice Address - Street 2:
Practice Address - City:CHICO
Practice Address - State:CA
Practice Address - Zip Code:95926-2213
Practice Address - Country:US
Practice Address - Phone:530-342-4395
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-01-07
Last Update Date:2016-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL20111020948363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily