Provider Demographics
NPI:1578930111
Name:PRICE, CHRISTINA (CHP-C)
Entity Type:Individual
Prefix:
First Name:CHRISTINA
Middle Name:
Last Name:PRICE
Suffix:
Gender:F
Credentials:CHP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1035 HELEN DR
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46240-3008
Mailing Address - Country:US
Mailing Address - Phone:317-710-7386
Mailing Address - Fax:
Practice Address - Street 1:1035 HELEN DR
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46240-3008
Practice Address - Country:US
Practice Address - Phone:317-710-7386
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-08-31
Last Update Date:2015-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist