Provider Demographics
NPI:1407329337
Name:AMBE, CHRISTINA SIRRI
Entity Type:Individual
Prefix:
First Name:CHRISTINA
Middle Name:SIRRI
Last Name:AMBE
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 1:4615 BLACKWOOD RD
Mailing Address - Street 2:
Mailing Address - City:BELTSVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20705-2526
Mailing Address - Country:US
Mailing Address - Phone:240-351-3248
Mailing Address - Fax:
Practice Address - Street 1:4615 BLACKWOOD RD
Practice Address - Street 2:
Practice Address - City:BELTSVILLE
Practice Address - State:MD
Practice Address - Zip Code:20705-2526
Practice Address - Country:US
Practice Address - Phone:240-351-3248
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-01-03
Last Update Date:2019-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCHHA14201374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide