Provider Demographics
NPI:1952627085
Name:INGLE, CHRISTA H (FNP-BC)
Entity Type:Individual
Prefix:
First Name:CHRISTA
Middle Name:H
Last Name:INGLE
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:CHRISTA
Other - Middle Name:R
Other - Last Name:CHOSEWOOD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3820 MEDICAL PARK DR
Mailing Address - Street 2:
Mailing Address - City:AUSTELL
Mailing Address - State:GA
Mailing Address - Zip Code:30106-1110
Mailing Address - Country:US
Mailing Address - Phone:770-948-6041
Mailing Address - Fax:770-948-7994
Practice Address - Street 1:3820 MEDICAL PARK DR
Practice Address - Street 2:
Practice Address - City:AUSTELL
Practice Address - State:GA
Practice Address - Zip Code:30106-1110
Practice Address - Country:US
Practice Address - Phone:770-948-6041
Practice Address - Fax:770-948-7994
Is Sole Proprietor?:No
Enumeration Date:2010-04-14
Last Update Date:2013-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA2009008446363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily