Provider Demographics
NPI:1164392940
Name:ALLIANCE, CHRYSTELE
Entity type:Individual
Prefix:
First Name:CHRYSTELE
Middle Name:
Last Name:ALLIANCE
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 1:145 HOWARD ST
Mailing Address - Street 2:
Mailing Address - City:SOUTH EASTON
Mailing Address - State:MA
Mailing Address - Zip Code:02375-1471
Mailing Address - Country:US
Mailing Address - Phone:678-602-1674
Mailing Address - Fax:
Practice Address - Street 1:145 HOWARD ST
Practice Address - Street 2:
Practice Address - City:SOUTH EASTON
Practice Address - State:MA
Practice Address - Zip Code:02375-1471
Practice Address - Country:US
Practice Address - Phone:678-602-1674
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-11-07
Last Update Date:2025-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MARN2307666163WC0400X, 163WC1500X, 163WC3500X, 163WE0003X, 163W00000X, 163WH0200X, 163WM0705X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
No163WC0400XNursing Service ProvidersRegistered NurseCase Management
No163WC1500XNursing Service ProvidersRegistered NurseCommunity Health
No163WC3500XNursing Service ProvidersRegistered NurseCardiac Rehabilitation
No163WE0003XNursing Service ProvidersRegistered NurseEmergency
No163WH0200XNursing Service ProvidersRegistered NurseHome Health
No163WM0705XNursing Service ProvidersRegistered NurseMedical-Surgical