Healthcare Provider Details

I. General information

NPI: 1225652753
Provider Name (Legal Business Name): BETTY CHRISTIAN FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/01/2020
Last Update Date: 01/11/2026
Certification Date: 01/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4605 TUTU PARK MALL STE 207
ST THOMAS VI
00802-1736
US

IV. Provider business mailing address

3406 GLACIER HWY
JUNEAU AK
99801-7251
US

V. Phone/Fax

Practice location:
  • Phone: 340-775-3700
  • Fax:
Mailing address:
  • Phone: 907-463-3303
  • Fax: 907-463-6889

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number214398
License Number StateAK
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number13498
License Number StateVI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: