Provider Demographics
NPI:1962767939
Name:BARRY, CHRISTINE SPIRES (ARNP)
Entity type:Individual
Prefix:
First Name:CHRISTINE
Middle Name:SPIRES
Last Name:BARRY
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:CHRISTINE
Other - Middle Name:MAUDIE
Other - Last Name:SPIRES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:5821 HOUND RUN RD
Mailing Address - Street 2:
Mailing Address - City:DE LEON SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:32130-4068
Mailing Address - Country:US
Mailing Address - Phone:386-676-7130
Mailing Address - Fax:
Practice Address - Street 1:320 N CLYDE MORRIS BLVD
Practice Address - Street 2:
Practice Address - City:DAYTONA BEACH
Practice Address - State:FL
Practice Address - Zip Code:32114-2744
Practice Address - Country:US
Practice Address - Phone:386-676-7130
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-07-05
Last Update Date:2014-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP9246095363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily