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Individual

CHRISTINA MARIE VAN GENNEP

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
ARNP

Contact information

Practice address
1108 ROSS CLARK CIR, DOTHAN, AL 36301-3022
(334) 793-8941
(334) 793-8093
Mailing address
7027 HUGH DR, PANAMA CITY, FL 32404-8420

Taxonomy

Speciality
Code
Description
License number
State
363LN0000X
Neonatal Nurse Practitioner
1-181102
AL
363LN0000X
Neonatal Nurse Practitioner
Primary
ARNP9262470
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
005969200
FL
01
Y0AU7
BLUE CROSS BLUE SHIELD
FL
Enumeration date
06/29/2012
Last updated
08/09/2025
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