Individual
CHRISTA M JEAVONS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
1026 COLD SPRINGS RD, LIVERPOOL, NY 13088-4343
(607) 624-7132
Mailing address
1026 COLD SPRINGS RD, LIVERPOOL, NY 13088-4343
(607) 624-7132
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
320072
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02957413
—
NY
Enumeration date
07/03/2007
Last updated
10/23/2015
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