Provider Demographics
NPI:1447519277
Name:PRINCE, CHRISTINE NOEL (RN)
Entity type:Individual
Prefix:MRS
First Name:CHRISTINE
Middle Name:NOEL
Last Name:PRINCE
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:610 SW 8TH ST
Mailing Address - Street 2:
Mailing Address - City:FORT LAUDERDALE
Mailing Address - State:FL
Mailing Address - Zip Code:33315-3828
Mailing Address - Country:US
Mailing Address - Phone:954-802-7670
Mailing Address - Fax:
Practice Address - Street 1:3601 W COMMERCIAL BLVD
Practice Address - Street 2:
Practice Address - City:FT LAUDERDALE
Practice Address - State:FL
Practice Address - Zip Code:33309-3300
Practice Address - Country:US
Practice Address - Phone:954-703-2931
Practice Address - Fax:954-585-9207
Is Sole Proprietor?:Yes
Enumeration Date:2012-05-14
Last Update Date:2016-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP9192537367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered