Basic Information
Provider Information
NPI: 1669745303
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: ARCEMENT
FirstName: CHRISTOPHER
MiddleName: BYRON
NamePrefix: MR.
NameSuffix:  
Credential: NURSE PRACTITIONER(N
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
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OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 149 DRINKWATER BLVD
Address2:  
City: BAY ST. LOUIS
State: MS
PostalCode: 39520
CountryCode: US
TelephoneNumber: 2284678600
FaxNumber: 2284678799
Practice Location
Address1: 5435 GEX RD.
Address2:  
City: DIAMONDHEAD
State: MS
PostalCode: 39525
CountryCode: US
TelephoneNumber: 2282558216
FaxNumber: 2282558219
Other Information
ProviderEnumerationDate: 02/10/2012
LastUpdateDate: 01/21/2014
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
363L00000XR859319MSY Physician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner 

No ID Information.


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