Provider Demographics
NPI:1457344616
Name:CHRISTOS, RUTH H (FNP-BC)
Entity Type:Individual
Prefix:
First Name:RUTH
Middle Name:H
Last Name:CHRISTOS
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 63314
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28263-3314
Mailing Address - Country:US
Mailing Address - Phone:828-696-1312
Mailing Address - Fax:828-696-1314
Practice Address - Street 1:6503 BREVARD RD
Practice Address - Street 2:
Practice Address - City:ETOWAH
Practice Address - State:NC
Practice Address - Zip Code:28729-8739
Practice Address - Country:US
Practice Address - Phone:828-890-4156
Practice Address - Fax:828-891-9276
Is Sole Proprietor?:No
Enumeration Date:2005-08-23
Last Update Date:2011-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC5004241363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC7004261Medicaid
NC2594229Medicare UPIN