Provider Demographics
NPI:1104691310
Name:FAUSH, CHRISTEN RASHARN (FNP-C)
Entity type:Individual
Prefix:
First Name:CHRISTEN
Middle Name:RASHARN
Last Name:FAUSH
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 1:165 JOHN THOMAS DR UNIT 4313
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:AL
Mailing Address - Zip Code:35757-7762
Mailing Address - Country:US
Mailing Address - Phone:205-529-4455
Mailing Address - Fax:
Practice Address - Street 1:101 RED HILL WAY
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:AL
Practice Address - Zip Code:35758-2568
Practice Address - Country:US
Practice Address - Phone:256-464-7855
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-11-17
Last Update Date:2024-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1-174111363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner