Provider Demographics
NPI:1568075216
Name:WHEELER, CHRISTA M (FNP-C)
Entity type:Individual
Prefix:MRS
First Name:CHRISTA
Middle Name:M
Last Name:WHEELER
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:CHRISTA
Other - Middle Name:MARIE
Other - Last Name:GIBSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:166 DAYTON DR
Mailing Address - Street 2:
Mailing Address - City:JOHNSON CITY
Mailing Address - State:TN
Mailing Address - Zip Code:37615-2508
Mailing Address - Country:US
Mailing Address - Phone:423-502-0112
Mailing Address - Fax:
Practice Address - Street 1:101 MED TECH PKWY STE 200
Practice Address - Street 2:
Practice Address - City:JOHNSON CITY
Practice Address - State:TN
Practice Address - Zip Code:37604-4001
Practice Address - Country:US
Practice Address - Phone:423-232-6120
Practice Address - Fax:423-232-6125
Is Sole Proprietor?:No
Enumeration Date:2020-08-24
Last Update Date:2024-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN35489363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily