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NPI Code Detail

MEDICARE: MR. CHRISTOPHER MICHAEL FLETCHER APRN, CPNP

MEDICARE:  MR. CHRISTOPHER MICHAEL FLETCHER  APRN, CPNP
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
1363LP0200XPediatric Nurse PractitionerAP06779LA

General Provider Information

NPI Number : 1881968915
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. CHRISTOPHER MICHAEL FLETCHER APRN, CPNP
Provider Business Mailing Address
First Line : 8004 DOUBLE LAKE RD
Second Line :
City : PICAYUNE
State : MS
Zip : 39466-2229
Country : US
Telephone Number : 601-798-9448
Fax Number :
Provider Business Practice Location Address
First Line : 2208 WASHINGTON ST
Second Line :
City : FRANKLINTON
State : LA
Zip : 70438-2501
Country : US
Telephone Number : 985-795-2228
Fax Number : 985-795-2289
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/07/2012
Last Update Date : 03/07/2012

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Directions to “ MR. CHRISTOPHER MICHAEL FLETCHER APRN, CPNP” Practice Location

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