Provider Demographics
NPI:1174626261
Name:SHANGREAUX, CHRISTINE A (RESPIRATORY THERAPIS)
Entity type:Individual
Prefix:MS
First Name:CHRISTINE
Middle Name:A
Last Name:SHANGREAUX
Suffix:
Gender:F
Credentials:RESPIRATORY THERAPIS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 778
Mailing Address - Street 2:
Mailing Address - City:ROSEBUD
Mailing Address - State:SD
Mailing Address - Zip Code:57570-0778
Mailing Address - Country:US
Mailing Address - Phone:605-747-4118
Mailing Address - Fax:
Practice Address - Street 1:SOLDIER CREEK ROAD
Practice Address - Street 2:ROSEBUD IHS HOSPITAL
Practice Address - City:ROSEBUD
Practice Address - State:SD
Practice Address - Zip Code:57570-0400
Practice Address - Country:US
Practice Address - Phone:605-747-3245
Practice Address - Fax:605-747-5348
Is Sole Proprietor?:No
Enumeration Date:2006-09-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SD0512227800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes227800000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRespiratory Therapist, Certified