Provider Demographics
NPI:1336689132
Name:DEEGINS, CHRISTINA M (HIS)
Entity Type:Individual
Prefix:
First Name:CHRISTINA
Middle Name:M
Last Name:DEEGINS
Suffix:
Gender:F
Credentials:HIS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2518 S HIGHWAY 77
Mailing Address - Street 2:SUITE A
Mailing Address - City:LYNN HAVEN
Mailing Address - State:FL
Mailing Address - Zip Code:32444-4785
Mailing Address - Country:US
Mailing Address - Phone:850-769-2705
Mailing Address - Fax:850-769-1097
Practice Address - Street 1:2518 S HIGHWAY 77
Practice Address - Street 2:SUITE A
Practice Address - City:LYNN HAVEN
Practice Address - State:FL
Practice Address - Zip Code:32444-4785
Practice Address - Country:US
Practice Address - Phone:850-769-2705
Practice Address - Fax:850-769-1097
Is Sole Proprietor?:No
Enumeration Date:2017-02-28
Last Update Date:2017-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAI 1002355A2700X
FLAS5266237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist
No2355A2700XSpeech, Language and Hearing Service ProvidersSpecialist/TechnologistAudiology Assistant