Provider Demographics
NPI:1467223669
Name:SANBORN, CHRISTINA MARIE
Entity Type:Individual
Prefix:
First Name:CHRISTINA
Middle Name:MARIE
Last Name:SANBORN
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 1:16801 BLACKWOOD RD
Mailing Address - Street 2:
Mailing Address - City:SHADE
Mailing Address - State:OH
Mailing Address - Zip Code:45776-9662
Mailing Address - Country:US
Mailing Address - Phone:740-517-5570
Mailing Address - Fax:
Practice Address - Street 1:16801 BLACKWOOD RD
Practice Address - Street 2:
Practice Address - City:SHADE
Practice Address - State:OH
Practice Address - Zip Code:45776-9662
Practice Address - Country:US
Practice Address - Phone:740-517-5570
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-01-16
Last Update Date:2024-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376J00000XNursing Service Related ProvidersHomemaker