Provider Demographics
NPI:1265950877
Name:GIVENS, CHRISTOPHER CLAYTON (NURSE PRACTIONER)
Entity type:Individual
Prefix:
First Name:CHRISTOPHER
Middle Name:CLAYTON
Last Name:GIVENS
Suffix:
Gender:
Credentials:NURSE PRACTIONER
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 490
Mailing Address - Street 2:
Mailing Address - City:MCCOMB
Mailing Address - State:MS
Mailing Address - Zip Code:39649-0490
Mailing Address - Country:US
Mailing Address - Phone:601-250-4366
Mailing Address - Fax:601-250-4367
Practice Address - Street 1:300 RAWLS DR STE 500
Practice Address - Street 2:
Practice Address - City:MCCOMB
Practice Address - State:MS
Practice Address - Zip Code:39648-2899
Practice Address - Country:US
Practice Address - Phone:601-249-4282
Practice Address - Fax:601-249-4852
Is Sole Proprietor?:No
Enumeration Date:2017-09-04
Last Update Date:2025-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS902070363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily