Provider Demographics
NPI:1992433270
Name:CHRISTIAN, ANNA NICOLE D (NP)
Entity type:Individual
Prefix:MRS
First Name:ANNA NICOLE
Middle Name:D
Last Name:CHRISTIAN
Suffix:
Gender:
Credentials:NP
Other - Prefix:
Other - First Name:ANNA NICOLE
Other - Middle Name:D
Other - Last Name:HALE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:NP
Mailing Address - Street 1:140 W 7TH ST
Mailing Address - Street 2:
Mailing Address - City:COOKEVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:38501-1726
Mailing Address - Country:US
Mailing Address - Phone:931-783-5582
Mailing Address - Fax:931-526-6760
Practice Address - Street 1:340 N CEDAR AVE
Practice Address - Street 2:
Practice Address - City:COOKEVILLE
Practice Address - State:TN
Practice Address - Zip Code:38501-2421
Practice Address - Country:US
Practice Address - Phone:931-783-5353
Practice Address - Fax:931-783-4994
Is Sole Proprietor?:No
Enumeration Date:2022-08-12
Last Update Date:2025-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN32041363L00000X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
TNQ076838Medicaid