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NPI Code Detail

MEDICARE: CHRISTINA IANNELLI FNP

MEDICARE: CHRISTINA IANNELLI FNP
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363LF0000XFamily Nurse Practitioner5003367NC

General Provider Information

NPI Number : 1790978609
Entity Type Code : Individual
Provider Name (Legal Business Name) : CHRISTINA IANNELLI FNP
Provider Business Mailing Address
First Line : 1142 N BROOME ST
Second Line :
City : WAXHAW
State : NC
Zip : 28173-9378
Country : US
Telephone Number : 794-843-4680
Fax Number : 704-843-4680
Provider Business Practice Location Address
First Line : 1142 N BROOME ST
Second Line :
City : WAXHAW
State : NC
Zip : 28173-9378
Country : US
Telephone Number : 794-843-4680
Fax Number : 704-843-4680
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/23/2007
Last Update Date : 01/27/2022

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