Provider Demographics
NPI:1750951349
Name:GARY, CHRISTINA TYREE (FNP)
Entity type:Individual
Prefix:
First Name:CHRISTINA
Middle Name:TYREE
Last Name:GARY
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1745 OLD SPRING HOUSE LN
Mailing Address - Street 2:
Mailing Address - City:DUNWOODY
Mailing Address - State:GA
Mailing Address - Zip Code:30338-6216
Mailing Address - Country:US
Mailing Address - Phone:706-814-8871
Mailing Address - Fax:
Practice Address - Street 1:1745 OLD SPRING HOUSE LN
Practice Address - Street 2:
Practice Address - City:DUNWOODY
Practice Address - State:GA
Practice Address - Zip Code:30338-6216
Practice Address - Country:US
Practice Address - Phone:706-814-8871
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-06-28
Last Update Date:2021-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN197577363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily