Provider Demographics
NPI:1770171738
Name:JEFFERSON, CHRISTEEN (AGPCNP-BC)
Entity type:Individual
Prefix:MRS
First Name:CHRISTEEN
Middle Name:
Last Name:JEFFERSON
Suffix:
Gender:F
Credentials:AGPCNP-BC
Other - Prefix:MISS
Other - First Name:CHRISTEEN
Other - Middle Name:L
Other - Last Name:BARABAD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:AGPCNP - BC
Mailing Address - Street 1:1100 N RALEIGH BLVD
Mailing Address - Street 2:STE 130
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27610-1081
Mailing Address - Country:US
Mailing Address - Phone:919-838-2887
Mailing Address - Fax:
Practice Address - Street 1:700 W HILLSBORO BLVD STE 203
Practice Address - Street 2:
Practice Address - City:DEERFIELD BEACH
Practice Address - State:FL
Practice Address - Zip Code:33441-1612
Practice Address - Country:US
Practice Address - Phone:954-990-2057
Practice Address - Fax:954-320-7341
Is Sole Proprietor?:No
Enumeration Date:2021-01-05
Last Update Date:2022-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC5013952363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health