Provider Demographics
NPI:1164978474
Name:HAIR BY CHRISTINA ANN
Entity Type:Organization
Organization Name:HAIR BY CHRISTINA ANN
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTINA
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:LOCKETT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:317-702-7169
Mailing Address - Street 1:600 E CARMEL DR
Mailing Address - Street 2:SUITE 214
Mailing Address - City:CARMEL
Mailing Address - State:IN
Mailing Address - Zip Code:46032-2803
Mailing Address - Country:US
Mailing Address - Phone:317-702-7169
Mailing Address - Fax:
Practice Address - Street 1:600 E CARMEL DR
Practice Address - Street 2:SUITE 214
Practice Address - City:CARMEL
Practice Address - State:IN
Practice Address - Zip Code:46032-2803
Practice Address - Country:US
Practice Address - Phone:317-702-7169
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-08-27
Last Update Date:2016-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
INBC20602823174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty