Provider Demographics
NPI:1003356015
Name:SOFINOWSKI, CHRISTA TERUMI
Entity Type:Individual
Prefix:
First Name:CHRISTA
Middle Name:TERUMI
Last Name:SOFINOWSKI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3540 MONAD RD
Mailing Address - Street 2:APT 4
Mailing Address - City:BILLINGS
Mailing Address - State:MT
Mailing Address - Zip Code:59102-6070
Mailing Address - Country:US
Mailing Address - Phone:443-931-6173
Mailing Address - Fax:
Practice Address - Street 1:SOUTH 7650 EAST 1010
Practice Address - Street 2:
Practice Address - City:CROW AGENCY
Practice Address - State:MT
Practice Address - Zip Code:59022
Practice Address - Country:US
Practice Address - Phone:406-638-3424
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-02-24
Last Update Date:2017-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR209680163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse