Provider Demographics
NPI:1700871191
Name:LANNOM, CHRISTINA L (DO)
Entity Type:Individual
Prefix:DR
First Name:CHRISTINA
Middle Name:L
Last Name:LANNOM
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4321 CAROTHERS PKWY
Mailing Address - Street 2:
Mailing Address - City:FRANKLIN
Mailing Address - State:TN
Mailing Address - Zip Code:37067-5909
Mailing Address - Country:US
Mailing Address - Phone:615-435-6690
Mailing Address - Fax:615-435-6692
Practice Address - Street 1:4321 CAROTHERS PKWY
Practice Address - Street 2:
Practice Address - City:FRANKLIN
Practice Address - State:TN
Practice Address - Zip Code:37067-5909
Practice Address - Country:US
Practice Address - Phone:615-435-6690
Practice Address - Fax:615-435-6692
Is Sole Proprietor?:No
Enumeration Date:2005-09-13
Last Update Date:2009-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN1509207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3307517Medicaid
TN3307518Medicare ID - Type Unspecified
TNH67803Medicare UPIN