Provider Demographics
NPI:1447751862
Name:BEARDEN, CHRISTINA F
Entity Type:Individual
Prefix:MRS
First Name:CHRISTINA
Middle Name:F
Last Name:BEARDEN
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 1:368 LEISURE LANE
Mailing Address - Street 2:PO
Mailing Address - City:ETOILE
Mailing Address - State:TX
Mailing Address - Zip Code:75944
Mailing Address - Country:US
Mailing Address - Phone:936-671-1128
Mailing Address - Fax:
Practice Address - Street 1:260 GOMER LN
Practice Address - Street 2:
Practice Address - City:HEMPHILL
Practice Address - State:TX
Practice Address - Zip Code:75948-5854
Practice Address - Country:US
Practice Address - Phone:936-201-9094
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-02-21
Last Update Date:2018-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX227135164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse