Provider Demographics
NPI:1861600272
Name:CLOUD, CHRISTY H (ANP)
Entity type:Individual
Prefix:MRS
First Name:CHRISTY
Middle Name:H
Last Name:CLOUD
Suffix:
Gender:F
Credentials:ANP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18 FORKED OAK DRIVE
Mailing Address - Street 2:
Mailing Address - City:HUMBOLDT
Mailing Address - State:TN
Mailing Address - Zip Code:38343
Mailing Address - Country:US
Mailing Address - Phone:731-855-0094
Mailing Address - Fax:731-855-0930
Practice Address - Street 1:2051 S. 45 BYPASS
Practice Address - Street 2:
Practice Address - City:TRENTON
Practice Address - State:TN
Practice Address - Zip Code:38382
Practice Address - Country:US
Practice Address - Phone:731-855-0094
Practice Address - Fax:731-855-0930
Is Sole Proprietor?:No
Enumeration Date:2007-05-18
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNAPN007031363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
TNAPN007031OtherAPN LICENSE NUMBER
TN3728972Medicare ID - Type UnspecifiedMEDICARE GROUP PROVIDER
TNAPN007031OtherAPN LICENSE NUMBER