Provider Demographics
NPI:1811479728
Name:CORRIVEAU, CHRISTOPHER (ARNP)
Entity type:Individual
Prefix:
First Name:CHRISTOPHER
Middle Name:
Last Name:CORRIVEAU
Suffix:
Gender:M
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:425 NURSING HOME DR
Mailing Address - Street 2:
Mailing Address - City:ARCADIA
Mailing Address - State:FL
Mailing Address - Zip Code:34266-3839
Mailing Address - Country:US
Mailing Address - Phone:863-993-2966
Mailing Address - Fax:863-494-5491
Practice Address - Street 1:425 NURSING HOME DR
Practice Address - Street 2:
Practice Address - City:ARCADIA
Practice Address - State:FL
Practice Address - Zip Code:34266-3839
Practice Address - Country:US
Practice Address - Phone:863-993-7296
Practice Address - Fax:863-494-5491
Is Sole Proprietor?:No
Enumeration Date:2018-09-06
Last Update Date:2024-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP9376103363L00000X
FLAPRN9376103363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner