Provider Demographics
NPI:1881327674
Name:MCDEARMONT, CHRISTIE
Entity type:Individual
Prefix:
First Name:CHRISTIE
Middle Name:
Last Name:MCDEARMONT
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 1:1634 HIGHWAY 531
Mailing Address - Street 2:
Mailing Address - City:MINDEN
Mailing Address - State:LA
Mailing Address - Zip Code:71055-6530
Mailing Address - Country:US
Mailing Address - Phone:225-329-1550
Mailing Address - Fax:225-529-3156
Practice Address - Street 1:1634 HIGHWAY 531
Practice Address - Street 2:
Practice Address - City:MINDEN
Practice Address - State:LA
Practice Address - Zip Code:71055-6530
Practice Address - Country:US
Practice Address - Phone:225-329-1550
Practice Address - Fax:225-529-3156
Is Sole Proprietor?:Yes
Enumeration Date:2022-07-08
Last Update Date:2023-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA226878363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology