Provider Demographics
NPI:1598253841
Name:WHITE, CHRISTINA J (LPN)
Entity Type:Individual
Prefix:
First Name:CHRISTINA
Middle Name:J
Last Name:WHITE
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:134 E PARK AVE APT C
Mailing Address - Street 2:
Mailing Address - City:MERCHANTVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:08109-2543
Mailing Address - Country:US
Mailing Address - Phone:215-667-4251
Mailing Address - Fax:
Practice Address - Street 1:134 E PARK AVE APT C
Practice Address - Street 2:
Practice Address - City:MERCHANTVILLE
Practice Address - State:NJ
Practice Address - Zip Code:08109-2543
Practice Address - Country:US
Practice Address - Phone:215-667-4251
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-04-23
Last Update Date:2018-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NP07403600164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse