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General NPI Number Information
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NPI Number | 1144731381
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Entity Type | Individual
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Provider Name | CHRISTOPHER CHARLES KILLIAN AGACNP-BC
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Gender | Male
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Dates
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Enumeration Date | 10/16/2017
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Last Update Date | 10/16/2017
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Provider Practice Location Address
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Address Line | 1600 11TH ST FL 3
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City | WICHITA FALLS
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State | TX
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Zip | 76301-4300
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Country | US
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Telephone | 940-764-3320
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 581
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City | HOLLIDAY
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State | TX
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Zip | 76366-0581
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Country | US
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Telephone | 940-636-2822
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Fax |
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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 | 363LA2100X
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Taxonomy Name | Acute Care Nurse Practitioner
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License Number | AP135397
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License Number State | TX
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