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NPI Code Detail

MEDICARE: DR. CHRISTINE A BOTTKOL ARNP-DNP

MEDICARE: DR. CHRISTINE A BOTTKOL ARNP-DNP
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
1363LF0000XFamily Nurse Practitioner9222669FL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
12012007553OTHERFLANCC
2F0512112OTHERFLCERTIFICATION AANP F0512112

General Provider Information

NPI Number : 1619222981
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. CHRISTINE A BOTTKOL ARNP-DNP
Provider Business Mailing Address
First Line : 510 AIRPORT RD
Second Line :
City : PANAMA CITY
State : FL
Zip : 32405-4011
Country : US
Telephone Number : 850-763-4669
Fax Number : 850-769-6673
Provider Business Practice Location Address
First Line : 510 AIRPORT RD
Second Line :
City : PANAMA CITY
State : FL
Zip : 32405-4011
Country : US
Telephone Number : 850-763-4669
Fax Number : 850-769-6673
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/23/2012
Last Update Date : 06/01/2026

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