Provider Demographics
NPI:1154915189
Name:GORBATOFF, CHRISTOPHER JUDE (NP-C)
Entity type:Individual
Prefix:
First Name:CHRISTOPHER
Middle Name:JUDE
Last Name:GORBATOFF
Suffix:
Gender:M
Credentials:NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1703 ANDRE ST
Mailing Address - Street 2:
Mailing Address - City:FLORENCE
Mailing Address - State:AL
Mailing Address - Zip Code:35630-2503
Mailing Address - Country:US
Mailing Address - Phone:931-477-0466
Mailing Address - Fax:
Practice Address - Street 1:1703 ANDRE ST
Practice Address - Street 2:
Practice Address - City:FLORENCE
Practice Address - State:AL
Practice Address - Zip Code:35630-2503
Practice Address - Country:US
Practice Address - Phone:931-477-0466
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-02-20
Last Update Date:2021-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1-184874363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily