Provider Demographics
NPI:1033835491
Name:WARD, CHRISTINA LANE
Entity Type:Individual
Prefix:
First Name:CHRISTINA
Middle Name:LANE
Last Name:WARD
Suffix:
Gender:F
Credentials:
Other - Prefix:MS
Other - First Name:CHRISTINA
Other - Middle Name:LANE
Other - Last Name:FANKHANEL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:178 PRIVATE DRIVE 19423
Mailing Address - Street 2:
Mailing Address - City:SOUTH POINT
Mailing Address - State:OH
Mailing Address - Zip Code:45680
Mailing Address - Country:US
Mailing Address - Phone:740-263-2626
Mailing Address - Fax:
Practice Address - Street 1:178 PRIVATE DRIVE 19423
Practice Address - Street 2:
Practice Address - City:SOUTH POINT
Practice Address - State:OH
Practice Address - Zip Code:45680-4568
Practice Address - Country:US
Practice Address - Phone:740-263-2626
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-10-18
Last Update Date:2022-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator