Provider Demographics
NPI:1588114854
Name:LORGEAT, CHRISTA (APRN, DNP)
Entity type:Individual
Prefix:DR
First Name:CHRISTA
Middle Name:
Last Name:LORGEAT
Suffix:
Gender:F
Credentials:APRN, DNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2050 HAVENDALE BLVD NW STE B
Mailing Address - Street 2:
Mailing Address - City:WINTER HAVEN
Mailing Address - State:FL
Mailing Address - Zip Code:33881-3828
Mailing Address - Country:US
Mailing Address - Phone:863-268-2211
Mailing Address - Fax:863-222-9343
Practice Address - Street 1:2050 HAVENDALE BLVD NW STE B
Practice Address - Street 2:
Practice Address - City:WINTER HAVEN
Practice Address - State:FL
Practice Address - Zip Code:33881-3828
Practice Address - Country:US
Practice Address - Phone:863-268-2211
Practice Address - Fax:863-222-9343
Is Sole Proprietor?:No
Enumeration Date:2016-10-10
Last Update Date:2023-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL9300625363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL023689700Medicaid
FLML4295261OtherDEA