Provider Demographics
NPI:1538282025
Name:RAWLINS, CHISTINA M
Entity Type:Individual
Prefix:
First Name:CHISTINA
Middle Name:M
Last Name:RAWLINS
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 1:50 N PORTLAND ST
Mailing Address - Street 2:
Mailing Address - City:FOND DU LAC
Mailing Address - State:WI
Mailing Address - Zip Code:54935-3412
Mailing Address - Country:US
Mailing Address - Phone:920-533-4011
Mailing Address - Fax:
Practice Address - Street 1:526 MILL ST
Practice Address - Street 2:
Practice Address - City:CAMPBELLSPORT
Practice Address - State:WI
Practice Address - Zip Code:53010-3502
Practice Address - Country:US
Practice Address - Phone:920-533-4011
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI87237-030163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse