=====================================================
General NPI Number Information
=====================================================
NPI Number | 1669582078
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | CHRISTINE A DEMERS CFNP
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 08/30/2006
-----------------------------------------------------
Last Update Date | 08/31/2007
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 5247 REEDER SCHOOL RD
-----------------------------------------------------
City | GREENBRIER
-----------------------------------------------------
State | TN
-----------------------------------------------------
Zip | 37073
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 615-428-7660
-----------------------------------------------------
Fax | 615-643-9333
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 5247 REEDER SCHOOL RD
-----------------------------------------------------
City | GREENBRIER
-----------------------------------------------------
State | TN
-----------------------------------------------------
Zip | 37073
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 615-428-7660
-----------------------------------------------------
Fax | 615-643-9333
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 363L00000X
-----------------------------------------------------
Taxonomy Name | Nurse Practitioner
-----------------------------------------------------
License Number | APN7720
-----------------------------------------------------
License Number State | TN
-----------------------------------------------------