Provider Demographics
NPI:1558484089
Name:GILLETTE, CHRISTINA M (NURSE)
Entity Type:Individual
Prefix:
First Name:CHRISTINA
Middle Name:M
Last Name:GILLETTE
Suffix:
Gender:F
Credentials:NURSE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11725 N ILLINOIS ST
Mailing Address - Street 2:SUITE 350
Mailing Address - City:CARMEL
Mailing Address - State:IN
Mailing Address - Zip Code:46032-3008
Mailing Address - Country:US
Mailing Address - Phone:317-814-4696
Mailing Address - Fax:317-814-4699
Practice Address - Street 1:11725 N ILLINOIS ST
Practice Address - Street 2:SUITE 350
Practice Address - City:CARMEL
Practice Address - State:IN
Practice Address - Zip Code:46032-3008
Practice Address - Country:US
Practice Address - Phone:317-814-4696
Practice Address - Fax:317-814-4699
Is Sole Proprietor?:No
Enumeration Date:2007-04-09
Last Update Date:2007-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN060698246ZS0410X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246ZS0410XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherSurgical Technologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN222120Medicare PIN