Healthcare Provider Details

I. General information

NPI: 1912664822
Provider Name (Legal Business Name): CHRISTINA CARLTON APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/27/2021
Last Update Date: 05/11/2022
Certification Date: 05/11/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6440 W NEWBERRY RD STE 409
GAINESVILLE FL
32605-4370
US

IV. Provider business mailing address

1406 NW 117TH TER
GAINESVILLE FL
32606-0424
US

V. Phone/Fax

Practice location:
  • Phone: 352-333-6161
  • Fax: 352-333-6162
Mailing address:
  • Phone: 352-207-4411
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPRN11016743
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: