Provider Demographics
NPI:1326749854
Name:WAVE, CHRISTIE O
Entity type:Individual
Prefix:
First Name:CHRISTIE
Middle Name:O
Last Name:WAVE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2507 HARRISON AVE UNIT 200
Mailing Address - Street 2:CHRISTIE.WAVE@CLEARWAYPAIN.COM
Mailing Address - City:PANAMA CITY
Mailing Address - State:FL
Mailing Address - Zip Code:32405
Mailing Address - Country:US
Mailing Address - Phone:850-484-4080
Mailing Address - Fax:
Practice Address - Street 1:2507 HARRISON AVE UNIT 200
Practice Address - Street 2:CHRISTIE.WAVE@CLEARWAYPAIN.COM
Practice Address - City:PANAMA CITY
Practice Address - State:FL
Practice Address - Zip Code:32405
Practice Address - Country:US
Practice Address - Phone:850-484-4080
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-03-13
Last Update Date:2025-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN11024988363L00000X, 363LF0000X
FL11024988363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner