Provider Demographics
NPI:1922596105
Name:TEIXEIRA- CONCEICAO, CHRISTINA M (FNP-C)
Entity Type:Individual
Prefix:
First Name:CHRISTINA
Middle Name:M
Last Name:TEIXEIRA- CONCEICAO
Suffix:
Gender:F
Credentials: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:PO BOX 102222
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30368-2222
Mailing Address - Country:US
Mailing Address - Phone:239-274-8200
Mailing Address - Fax:
Practice Address - Street 1:28115 WESLEY CHAPEL BLVD
Practice Address - Street 2:
Practice Address - City:WESLEY CHAPEL
Practice Address - State:FL
Practice Address - Zip Code:33543-3204
Practice Address - Country:US
Practice Address - Phone:813-915-5459
Practice Address - Fax:813-373-5659
Is Sole Proprietor?:Yes
Enumeration Date:2018-04-24
Last Update Date:2023-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARN712361163W00000X
IL041.404456163W00000X
IL209017613363LF0000X
PASP019731363LF0000X
FLAPRN11023557363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse