Provider Demographics
NPI:1427606177
Name:NICHOLAS, CHRISTI GATLIN
Entity type:Individual
Prefix:
First Name:CHRISTI
Middle Name:GATLIN
Last Name:NICHOLAS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:37215 FRAZEE HILL RD
Mailing Address - Street 2:
Mailing Address - City:DADE CITY
Mailing Address - State:FL
Mailing Address - Zip Code:33523-6368
Mailing Address - Country:US
Mailing Address - Phone:850-637-4206
Mailing Address - Fax:
Practice Address - Street 1:37215 FRAZEE HILL RD
Practice Address - Street 2:
Practice Address - City:DADE CITY
Practice Address - State:FL
Practice Address - Zip Code:33523-6368
Practice Address - Country:US
Practice Address - Phone:850-637-4206
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-08-27
Last Update Date:2019-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747A0650XNursing Service Related ProvidersTechnicianAttendant Care Provider