Provider Demographics
NPI:1104979954
Name:BYCZKOSKI, CHRISTY N (FNP)
Entity type:Individual
Prefix:
First Name:CHRISTY
Middle Name:N
Last Name:BYCZKOSKI
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1601 FAIR RD
Mailing Address - Street 2:SUITE 400
Mailing Address - City:STATESBORO
Mailing Address - State:GA
Mailing Address - Zip Code:30458-1698
Mailing Address - Country:US
Mailing Address - Phone:912-871-8900
Mailing Address - Fax:912-871-8901
Practice Address - Street 1:1601 FAIR RD
Practice Address - Street 2:SUITE 400
Practice Address - City:STATESBORO
Practice Address - State:GA
Practice Address - Zip Code:30458-1698
Practice Address - Country:US
Practice Address - Phone:912-871-8900
Practice Address - Fax:912-871-8901
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-18
Last Update Date:2007-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN144570363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily