MEDICARE: CHRISTINE PAULK FNP-BC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LF0000X	Family Nurse Practitioner	RN227377	GA

General Provider Information

NPI Number	:	1245091198
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHRISTINE PAULK FNP-BC

Provider Business Mailing Address
First Line	:	1909 US HIGHWAY 82 W STE 3AND4
Second Line	:
City	:	TIFTON
State	:	GA
Zip	:	31793-8200
Country	:	US
Telephone Number	:	229-445-3509
Fax Number	:

Provider Business Practice Location Address
First Line	:	201 N BARTOW ST
Second Line	:
City	:	NASHVILLE
State	:	GA
Zip	:	31639-1435
Country	:	US
Telephone Number	:	912-544-4569
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/18/2024
Last Update Date	:	09/23/2025

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