Individual
CHRISTOPHER ALLEN TICKLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
ANP-BC
Contact information
Practice address
4 E JACKSON BLVD, SAVANNAH, GA 31405
(912) 355-1010
(912) 351-0589
Mailing address
4 E JACKSON BLVD, SAVANNAH, GA 31405-5895
(912) 355-1010
(912) 351-0589
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
15703
TN
363LA2200X
Adult Health Nurse Practitioner
15703
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1525841
—
TN
Enumeration date
03/11/2011
Last updated
03/29/2019
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