Healthcare Provider Details

I. General information

NPI: 1629314943
Provider Name (Legal Business Name): CHRISTINA NICOLE PHILLIPS ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/13/2012
Last Update Date: 07/24/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1658 ST VINCENTS WAY STE 320
MIDDLEBURG FL
32068-8459
US

IV. Provider business mailing address

4205 BELFORT RD STE 4015
JACKSONVILLE FL
32216-3623
US

V. Phone/Fax

Practice location:
  • Phone: 904-602-4330
  • Fax: 904-602-4371
Mailing address:
  • Phone: 904-450-6063
  • Fax: 904-450-6401

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0200X
TaxonomyPediatric Nurse Practitioner
License NumberARNP 9273354
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: