Provider Demographics
NPI:1114645041
Name:CHRISTOPHER, ISABELLA (BS)
Entity Type:Individual
Prefix:MISS
First Name:ISABELLA
Middle Name:
Last Name:CHRISTOPHER
Suffix:
Gender:F
Credentials:BS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2466 N 134TH AVE
Mailing Address - Street 2:
Mailing Address - City:GOODYEAR
Mailing Address - State:AZ
Mailing Address - Zip Code:85395-2109
Mailing Address - Country:US
Mailing Address - Phone:330-554-8587
Mailing Address - Fax:
Practice Address - Street 1:1840 N 95TH AVE STE 160
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85037-4313
Practice Address - Country:US
Practice Address - Phone:623-234-9836
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-08-17
Last Update Date:2022-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program