Provider Demographics
NPI:1407106313
Name:KILLEBREW, CHRISTIE LASHUN (LPN)
Entity Type:Individual
Prefix:MRS
First Name:CHRISTIE
Middle Name:LASHUN
Last Name:KILLEBREW
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1498 E 175TH ST
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44110-2939
Mailing Address - Country:US
Mailing Address - Phone:216-383-1485
Mailing Address - Fax:
Practice Address - Street 1:1498 E 175TH ST
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44110-2939
Practice Address - Country:US
Practice Address - Phone:216-383-1485
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-09-18
Last Update Date:2013-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH129551164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse