Provider Demographics
NPI:1932711678
Name:CHRISTOFFERSON, JULIE JAYNE
Entity type:Individual
Prefix:
First Name:JULIE
Middle Name:JAYNE
Last Name:CHRISTOFFERSON
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 1:8573 WILBURN CV
Mailing Address - Street 2:
Mailing Address - City:NAVARRE
Mailing Address - State:FL
Mailing Address - Zip Code:32566-6668
Mailing Address - Country:US
Mailing Address - Phone:850-533-5632
Mailing Address - Fax:
Practice Address - Street 1:4009 DEERWOOD CIR
Practice Address - Street 2:
Practice Address - City:PACE
Practice Address - State:FL
Practice Address - Zip Code:32571-1108
Practice Address - Country:US
Practice Address - Phone:850-855-9999
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-08-22
Last Update Date:2020-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747A0650XNursing Service Related ProvidersTechnicianAttendant Care Provider
No374U00000XNursing Service Related ProvidersHome Health Aide