Healthcare Provider Details

I. General information

NPI: 1215020193
Provider Name (Legal Business Name): CHRISTIE C HULL CFNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/02/2006
Last Update Date: 09/09/2020
Certification Date: 09/09/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

305 HIGHWAY 51
RIDGELAND MS
39157-3428
US

IV. Provider business mailing address

305 HIGHWAY 51
RIDGELAND MS
39157-3428
US

V. Phone/Fax

Practice location:
  • Phone: 601-856-9980
  • Fax: 601-856-9994
Mailing address:
  • Phone: 601-856-9980
  • Fax: 601-856-9994

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberR748942
License Number StateMS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: