Provider Demographics
NPI:1437801917
Name:HOUSTON, CHRISTINA (LPN)
Entity Type:Individual
Prefix:
First Name:CHRISTINA
Middle Name:
Last Name:HOUSTON
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 1:4460 INNS BROOK DR
Mailing Address - Street 2:
Mailing Address - City:SNELLVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30039-5667
Mailing Address - Country:US
Mailing Address - Phone:678-851-2040
Mailing Address - Fax:
Practice Address - Street 1:4460 INNS BROOK DR
Practice Address - Street 2:
Practice Address - City:SNELLVILLE
Practice Address - State:GA
Practice Address - Zip Code:30039-5667
Practice Address - Country:US
Practice Address - Phone:678-851-2040
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-01-25
Last Update Date:2022-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA5177790164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse