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General NPI Number Information
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NPI Number | 1104271444
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Entity Type | Individual
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Provider Name | CHRISTY M CHONG ARNP
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Gender | Female
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Dates
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Enumeration Date | 04/24/2016
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Last Update Date | 11/25/2024
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Provider Practice Location Address
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Address Line | 1851 OLD MOULTRIE RD STE A
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City | SAINT AUGUSTINE
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State | FL
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Zip | 32084-4167
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Country | US
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Telephone | 904-824-8088
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Fax | 904-826-4105
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Provider Business Mailing Address
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Address Line | 1851 OLD MOULTRIE RD STE A
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City | SAINT AUGUSTINE
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State | FL
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Zip | 32084-4167
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Country | US
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Telephone | 904-824-8088
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Fax | 904-826-4105
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 9229375
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License Number State | FL
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