Healthcare Provider Details

I. General information

NPI: 1992771778
Provider Name (Legal Business Name): CHRISTOPHER ALLEN WEATHERSPOON MS, RN, CS-FNP
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 02/23/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

LAPOINTE HEALTH CLINIC 5979 DESERT STORM AVE.
FT. CAMPBELL KY
42223
US

IV. Provider business mailing address

315 STONEY LN
CADIZ KY
42211-7435
US

V. Phone/Fax

Practice location:
  • Phone: 270-798-8592
  • Fax:
Mailing address:
  • Phone: 270-522-7272
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: