Healthcare Provider Details

I. General information

NPI: 1639085574
Provider Name (Legal Business Name): CHRISTI LYNN PATRICK BHSRT(R)(CT)
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: CHRISTI LYNN POWELL

II. Dates (important events)

Enumeration Date: 08/20/2026
Last Update Date: 08/20/2026
Certification Date: 08/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7601 SOUTHCREST PKWY
SOUTHAVEN MS
38671-4742
US

IV. Provider business mailing address

1669 TARA DR
HERNANDO MS
38632-1634
US

V. Phone/Fax

Practice location:
  • Phone: 662-772-3770
  • Fax:
Mailing address:
  • Phone: 901-421-1905
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2471C3402X
TaxonomyRadiography Radiologic Technologist
License Number552057
License Number State
# 2
Primary TaxonomyY
Taxonomy Code2471C3401X
TaxonomyComputed Tomography Radiologic Technologist
License Number552057
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: