Provider Demographics
NPI:1083895668
Name:PARRA, CHRISTINE CAROL (LPN)
Entity Type:Individual
Prefix:
First Name:CHRISTINE
Middle Name:CAROL
Last Name:PARRA
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:208 RICHBELL RD
Mailing Address - Street 2:
Mailing Address - City:MAMARONECK
Mailing Address - State:NY
Mailing Address - Zip Code:10543-3225
Mailing Address - Country:US
Mailing Address - Phone:914-834-1356
Mailing Address - Fax:
Practice Address - Street 1:208 RICHBELL RD
Practice Address - Street 2:
Practice Address - City:MAMARONECK
Practice Address - State:NY
Practice Address - Zip Code:10543-3225
Practice Address - Country:US
Practice Address - Phone:914-834-1356
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-11-24
Last Update Date:2007-11-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY145964-1164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse