Provider Demographics
NPI:1154805190
Name:LEE, CHRISTINA (FNP-BC, ARNP)
Entity type:Individual
Prefix:
First Name:CHRISTINA
Middle Name:
Last Name:LEE
Suffix:
Gender:F
Credentials:FNP-BC, ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3100 W ROLLING HILLS CIR APT 603
Mailing Address - Street 2:
Mailing Address - City:DAVIE
Mailing Address - State:FL
Mailing Address - Zip Code:33328-1958
Mailing Address - Country:US
Mailing Address - Phone:301-979-8203
Mailing Address - Fax:
Practice Address - Street 1:3100 W ROLLING HILLS CIR APT 603
Practice Address - Street 2:
Practice Address - City:DAVIE
Practice Address - State:FL
Practice Address - Zip Code:33328-1958
Practice Address - Country:US
Practice Address - Phone:301-979-8203
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-09-15
Last Update Date:2018-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP9377433363LF0000X, 363LP2300X, 363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care