Provider Demographics
NPI:1831946300
Name:SUTHERLAND, CHRISTINE ELIZABETH (FNP-C)
Entity type:Individual
Prefix:
First Name:CHRISTINE
Middle Name:ELIZABETH
Last Name:SUTHERLAND
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 1:2772 ROOSEVELT ST UNIT 652
Mailing Address - Street 2:
Mailing Address - City:CARLSBAD
Mailing Address - State:CA
Mailing Address - Zip Code:92018-8028
Mailing Address - Country:US
Mailing Address - Phone:760-814-0604
Mailing Address - Fax:
Practice Address - Street 1:1706 DESCANSO AVE
Practice Address - Street 2:
Practice Address - City:SAN MARCOS
Practice Address - State:CA
Practice Address - Zip Code:92078-2514
Practice Address - Country:US
Practice Address - Phone:760-280-2230
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-05-02
Last Update Date:2024-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA9502953363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily