Provider Demographics
NPI:1972952869
Name:EZEIHEKAIBEE, CHRISTIANA (FNP-C)
Entity Type:Individual
Prefix:
First Name:CHRISTIANA
Middle Name:
Last Name:EZEIHEKAIBEE
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 1:5615 OLD NATIONAL HWY
Mailing Address - Street 2:
Mailing Address - City:COLLEGE PARK
Mailing Address - State:GA
Mailing Address - Zip Code:30349-3811
Mailing Address - Country:US
Mailing Address - Phone:770-997-2900
Mailing Address - Fax:679-949-9310
Practice Address - Street 1:5615 OLD NATIONAL HWY
Practice Address - Street 2:
Practice Address - City:COLLEGE PARK
Practice Address - State:GA
Practice Address - Zip Code:30349-3811
Practice Address - Country:US
Practice Address - Phone:770-997-2900
Practice Address - Fax:679-949-9310
Is Sole Proprietor?:Yes
Enumeration Date:2016-06-10
Last Update Date:2016-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN127623363LF0000X, 363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily