Basic Information
| Provider Information | |||||||||
| NPI: | 1962458919 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | BARTEE | ||||||||
| FirstName: | CHRIS | ||||||||
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| Credential: | ARPN, BC | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 634909 | ||||||||
| Address2: | |||||||||
| City: | CINCINNATI | ||||||||
| State: | OH | ||||||||
| PostalCode: | 452634909 | ||||||||
| CountryCode: | US | ||||||||
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| Practice Location | |||||||||
| Address1: | 1990 HOLTON AVE E | ||||||||
| Address2: | |||||||||
| City: | BIG STONE GAP | ||||||||
| State: | VA | ||||||||
| PostalCode: | 242193350 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2765233111 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 05/25/2006 | ||||||||
| LastUpdateDate: | 11/19/2010 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363L00000X | 0024166579 | VA | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | 207P00000X | 11581 | TN | N | Allopathic & Osteopathic Physicians | Emergency Medicine |
ID Information
| ID | Type | State | Issuer | Description | P00364653 | 01 | TN | RAILROAD MEDICARE | OTHER | 3643888 | 05 | TN | MEDICAID | P00385289 | 01 | VA | RAILROAD MEDICARE | OTHER | 4133719 | 01 | TN | BC BS | OTHER |