Fargo, Christine Marie
Fargo, Christine Marie is an individual health care provider with primary practice located at 2300 State Road 524 Suite 104, Cocoa FL 32926-5894. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Family, which is considered as her primary health care specialty. Fargo, Christine Marie can be contacted via phone (321) 868-8320.Contact Information
Primary practice address
2300 State Road 524 Suite 104
Cocoa FL 32926-5894
Phone: (321) 868-8320
Fax: (321) 632-3445
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Family | 363LF0000X | ARNP3328432 | Florida |
Profile Details
| NPI number | 1770584542 |
|---|---|
| LBN Legal business name | Fargo, Christine Marie |
| Credentials | ARNP |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Aug 3rd, 2005 |
| Last updated | May 29th, 2018 - about 6 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1770584542 | NPPES |
| Florida | MEDICAID | 306115900 |
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