Provider Demographics
NPI:1598146243
Name:ULIBARRI, CHRISTINA NOEL (MD)
Entity Type:Individual
Prefix:DR
First Name:CHRISTINA
Middle Name:NOEL
Last Name:ULIBARRI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:CHRISTINA
Other - Middle Name:NOEL
Other - Last Name:TRUJILLO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:550 UNIVERSITY BLVD
Mailing Address - Street 2:STE 2440
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46202-5149
Mailing Address - Country:US
Mailing Address - Phone:317-948-5923
Mailing Address - Fax:
Practice Address - Street 1:2055 S PACHECO ST
Practice Address - Street 2:
Practice Address - City:SANTA FE
Practice Address - State:NM
Practice Address - Zip Code:87505-3997
Practice Address - Country:US
Practice Address - Phone:505-984-0303
Practice Address - Fax:505-984-1116
Is Sole Proprietor?:No
Enumeration Date:2015-06-17
Last Update Date:2019-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN11018453A390200000X
NMMD2019-0657207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN11018453AOtherINDIANA PROFESSIONAL LICENSING AGENCY