Provider Demographics
NPI:1831506401
Name:GADSON, CHRISTY LEE (FNP-C)
Entity type:Individual
Prefix:
First Name:CHRISTY
Middle Name:LEE
Last Name:GADSON
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2831 MAGUIRE RD
Mailing Address - Street 2:
Mailing Address - City:WINDERMERE
Mailing Address - State:FL
Mailing Address - Zip Code:34786-6057
Mailing Address - Country:US
Mailing Address - Phone:407-428-5751
Mailing Address - Fax:407-447-7245
Practice Address - Street 1:2831 MAGUIRE RD
Practice Address - Street 2:
Practice Address - City:WINDERMERE
Practice Address - State:FL
Practice Address - Zip Code:34786-6057
Practice Address - Country:US
Practice Address - Phone:407-428-5751
Practice Address - Fax:407-447-7245
Is Sole Proprietor?:No
Enumeration Date:2014-07-16
Last Update Date:2017-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP9383516363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL13185200Medicaid