Individual
CHRISTINE ROSEANN IDEMUDIA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN-CNP
Contact information
Practice address
8739 DAVIS BLVD STE 100, KELLER, TX 76248-0309
(817) 476-1226
(888) 355-4603
Mailing address
8739 DAVIS BLVD STE 100, KELLER, TX 76248-0309
(817) 476-1226
(888) 355-4603
Taxonomy
Speciality
Code
Description
License number
State
171400000X
Health & Wellness Coach
—
—
363LF0000X
Family Nurse Practitioner
Primary
67455
NM
363LP2300X
Primary Care Nurse Practitioner
67455
NM
Other
Enumeration date
03/26/2022
Last updated
08/05/2026
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