Provider Demographics
NPI:1740319839
Name:STAPLES, CHRISTA (CPNP, FNP-C, NNP)
Entity type:Individual
Prefix:MS
First Name:CHRISTA
Middle Name:
Last Name:STAPLES
Suffix:
Gender:F
Credentials:CPNP, FNP-C, NNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:116 MADISON PL
Mailing Address - Street 2:
Mailing Address - City:HATTIESBURG
Mailing Address - State:MS
Mailing Address - Zip Code:39402-8339
Mailing Address - Country:US
Mailing Address - Phone:601-466-3424
Mailing Address - Fax:
Practice Address - Street 1:431 BROAD ST
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:MS
Practice Address - Zip Code:39429-3056
Practice Address - Country:US
Practice Address - Phone:601-466-3424
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-05
Last Update Date:2025-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MSR857329363LF0000X, 363LP0200X, 363LP0200X
TXAP121222363LP0200X, 363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS00424220Medicaid
MS1740319839Medicaid