Individual provider · Type 1 NPI
Christina Marie Ivy, FNP-C
Family Nurse Practitioner · O Fallon, MO
NPI number
1104394899
Active
Practice location
2765 Red Cedar Parc Dr S
O Fallon, MO 63368-6609
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Family Nurse Practitioner Primary | 363LF0000X | 2018040232 (MO) |
Family Nurse Practitioner: Definition to come...
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About NPI 1104394899
Christina Marie Ivy, FNP-C's National Provider Identifier is 1104394899, issued on Nov 12, 2018. The primary taxonomy on file is Family Nurse Practitioner (363LF0000X), and the practice location is in O Fallon, MO. The record was last updated on Nov 12, 2018.