Provider Demographics
NPI:1194198143
Name:CHRISTINA LAURY
Entity Type:Organization
Organization Name:CHRISTINA LAURY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LPN
Authorized Official - Prefix:MISS
Authorized Official - First Name:CHRISTINA
Authorized Official - Middle Name:AISHA
Authorized Official - Last Name:LAURY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:513-405-6031
Mailing Address - Street 1:7666 CLOVERNOOK AVE
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45231-3506
Mailing Address - Country:US
Mailing Address - Phone:513-405-6031
Mailing Address - Fax:
Practice Address - Street 1:7666 CLOVERNOOK AVE
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45231-3506
Practice Address - Country:US
Practice Address - Phone:513-405-6031
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-11-12
Last Update Date:2015-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH127049313M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes313M00000XNursing & Custodial Care FacilitiesNursing Facility/Intermediate Care Facility