Provider Demographics
NPI:1992194021
Name:ROPER, CHRISTINE THOMAS (FNP)
Entity Type:Individual
Prefix:MS
First Name:CHRISTINE
Middle Name:THOMAS
Last Name:ROPER
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:MS
Other - First Name:CHRISTINE
Other - Middle Name:LYNN
Other - Last Name:ROPER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:FNP
Mailing Address - Street 1:2620 ELM HILL PIKE
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37214-3108
Mailing Address - Country:US
Mailing Address - Phone:615-425-4211
Mailing Address - Fax:615-425-4268
Practice Address - Street 1:12 BIA 120
Practice Address - Street 2:PO BOX 310
Practice Address - City:PINE HILL
Practice Address - State:NM
Practice Address - Zip Code:87357-0310
Practice Address - Country:US
Practice Address - Phone:505-775-3271
Practice Address - Fax:706-387-7638
Is Sole Proprietor?:No
Enumeration Date:2015-01-13
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA184167363LF0000X, 363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NM87984083Medicaid