Provider Demographics
NPI:1669582078
Name:DEMERS, CHRISTINE A (CFNP)
Entity type:Individual
Prefix:MRS
First Name:CHRISTINE
Middle Name:A
Last Name:DEMERS
Suffix:
Gender:F
Credentials:CFNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5247 REEDER SCHOOL RD
Mailing Address - Street 2:
Mailing Address - City:GREENBRIER
Mailing Address - State:TN
Mailing Address - Zip Code:37073
Mailing Address - Country:US
Mailing Address - Phone:615-428-7660
Mailing Address - Fax:615-643-9333
Practice Address - Street 1:5247 REEDER SCHOOL RD
Practice Address - Street 2:
Practice Address - City:GREENBRIER
Practice Address - State:TN
Practice Address - Zip Code:37073
Practice Address - Country:US
Practice Address - Phone:615-428-7660
Practice Address - Fax:615-643-9333
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-30
Last Update Date:2007-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNAPN7720363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN4103519OtherBLUE CROSS BLUE SHIELD
TN4103519OtherTENNCARE SELECT
TN3906110Medicaid
TN4103519OtherBLUE CROSS BLUE SHIELD
TN4103519OtherTENNCARE SELECT