Provider Demographics
NPI:1104041169
Name:STORTECKY, CHRISTINE (LPN)
Entity Type:Individual
Prefix:MS
First Name:CHRISTINE
Middle Name:
Last Name:STORTECKY
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 1:4870 BIXBY RIDGE DR E
Mailing Address - Street 2:
Mailing Address - City:GROVEPORT
Mailing Address - State:OH
Mailing Address - Zip Code:43125-1164
Mailing Address - Country:US
Mailing Address - Phone:614-906-9841
Mailing Address - Fax:614-492-4870
Practice Address - Street 1:4870 BIXBY RIDGE DR E
Practice Address - Street 2:
Practice Address - City:GROVEPORT
Practice Address - State:OH
Practice Address - Zip Code:43125-1164
Practice Address - Country:US
Practice Address - Phone:614-906-9841
Practice Address - Fax:614-492-4870
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-16
Last Update Date:2008-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPN 094547164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse