Healthcare Provider Details

I. General information

NPI: 1376362467
Provider Name (Legal Business Name): CHRISTOPHER MICHAEL NEASE APRN, FNP-C
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/07/2024
Last Update Date: 08/04/2026
Certification Date: 08/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1332 SOUTHERN DR
STATESBORO GA
30460-1360
US

IV. Provider business mailing address

1332 SOUTHERN DR
STATESBORO GA
30460-1360
US

V. Phone/Fax

Practice location:
  • Phone: 912-601-7483
  • Fax:
Mailing address:
  • Phone: 912-601-7483
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPRN-NP264108
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: