Provider Demographics
NPI:1962722769
Name:CHRISTOPHER, JENNIFER PUTMAN (NP)
Entity type:Individual
Prefix:
First Name:JENNIFER
Middle Name:PUTMAN
Last Name:CHRISTOPHER
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1436
Mailing Address - Street 2:
Mailing Address - City:ATHENS
Mailing Address - State:AL
Mailing Address - Zip Code:35612-6436
Mailing Address - Country:US
Mailing Address - Phone:256-772-3857
Mailing Address - Fax:
Practice Address - Street 1:209 FITNESS WAY
Practice Address - Street 2:
Practice Address - City:ATHENS
Practice Address - State:AL
Practice Address - Zip Code:35611-2451
Practice Address - Country:US
Practice Address - Phone:256-262-2190
Practice Address - Fax:256-262-2196
Is Sole Proprietor?:No
Enumeration Date:2010-06-03
Last Update Date:2023-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1-097287363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care