Provider Demographics
NPI:1588747018
Name:ALSUP, CHRIS MARIE (RN, CRNI)
Entity type:Individual
Prefix:
First Name:CHRIS
Middle Name:MARIE
Last Name:ALSUP
Suffix:
Gender:F
Credentials:RN, CRNI
Other - Prefix:
Other - First Name:CHRIS
Other - Middle Name:MARIE
Other - Last Name:DAHLEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:2860 BURGUNDY DR
Mailing Address - Street 2:
Mailing Address - City:CUMMING
Mailing Address - State:GA
Mailing Address - Zip Code:30041-8031
Mailing Address - Country:US
Mailing Address - Phone:770-889-9559
Mailing Address - Fax:
Practice Address - Street 1:1000 JOHNSON FERRY RD NE
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30342-1606
Practice Address - Country:US
Practice Address - Phone:404-851-8910
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IARN084114163WI0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WI0500XNursing Service ProvidersRegistered NurseInfusion Therapy