Healthcare Provider Details

I. General information

NPI: 1104856384
Provider Name (Legal Business Name): CHRISTINE F BYRER CFNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: CHRISTINE F CHRISTIE

II. Dates (important events)

Enumeration Date: 07/04/2006
Last Update Date: 10/01/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1673 N ROYAL ST
JACKSON TN
38301-3607
US

IV. Provider business mailing address

1673 N ROYAL ST
JACKSON TN
38301-3607
US

V. Phone/Fax

Practice location:
  • Phone: 731-265-1997
  • Fax: 731-265-0511
Mailing address:
  • Phone: 731-265-1997
  • Fax: 731-265-0511

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN95319
License Number StateTN
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPN6810
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: