Healthcare Provider Details

I. General information

NPI: 1447519277
Provider Name (Legal Business Name): CHRISTINE NOEL PRINCE RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/14/2012
Last Update Date: 09/13/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3601 W COMMERCIAL BLVD
FT LAUDERDALE FL
33309-3300
US

IV. Provider business mailing address

610 SW 8TH ST
FORT LAUDERDALE FL
33315-3828
US

V. Phone/Fax

Practice location:
  • Phone: 954-703-2931
  • Fax: 954-585-9207
Mailing address:
  • Phone: 954-802-7670
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License NumberARNP9192537
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: