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Individual

CHRISTI LEE SELF

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
F.N.P.

Contact information

Practice address
5604 E WHITE OAK LN, MARENGO, IN 47140-8413
(812) 365-3221
(812) 365-9502
Mailing address
420 W LONGEST ST, PAOLI, IN 47454-8821
(812) 723-3944
(812) 723-7991

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
28159185A
IN
363LF0000X
Family Nurse Practitioner
Primary
71003148A
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
201075360
IN
Enumeration date
11/20/2009
Last updated
10/24/2013
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