Healthcare Provider Details

I. General information

NPI: 1053814657
Provider Name (Legal Business Name): CHRISTOPHER SCOTT HOUSER
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/10/2018
Last Update Date: 07/18/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1210 S OLD DIXIE HWY
JUPITER FL
33458
US

IV. Provider business mailing address

324 COMMONS WAY
PALM BEACH GARDENS FL
33418-3989
US

V. Phone/Fax

Practice location:
  • Phone: 561-263-2234
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License NumberARNP9419453
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: