Provider Demographics
NPI:1982457362
Name:ELDREDGE-BROWN, CHRISTINE (RN, BSN, FNP STUDENT)
Entity Type:Individual
Prefix:
First Name:CHRISTINE
Middle Name:
Last Name:ELDREDGE-BROWN
Suffix:
Gender:F
Credentials:RN, BSN, FNP STUDENT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 980861
Mailing Address - Street 2:
Mailing Address - City:PARK CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84098-0837
Mailing Address - Country:US
Mailing Address - Phone:435-901-3065
Mailing Address - Fax:
Practice Address - Street 1:1213 FOXCREST DR
Practice Address - Street 2:
Practice Address - City:PARK CITY
Practice Address - State:UT
Practice Address - Zip Code:84098-6330
Practice Address - Country:US
Practice Address - Phone:435-901-3065
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-04-08
Last Update Date:2024-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT2616013102163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse