Provider Demographics
NPI:1619003720
Name:CRISTIANI, SALLIE CAROL (RN)
Entity Type:Individual
Prefix:MS
First Name:SALLIE
Middle Name:CAROL
Last Name:CRISTIANI
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8548 W EVA ST
Mailing Address - Street 2:
Mailing Address - City:PEORIA
Mailing Address - State:AZ
Mailing Address - Zip Code:85345-5313
Mailing Address - Country:US
Mailing Address - Phone:623-435-6303
Mailing Address - Fax:
Practice Address - Street 1:8548 W EVA ST
Practice Address - Street 2:
Practice Address - City:PEORIA
Practice Address - State:AZ
Practice Address - Zip Code:85345-5313
Practice Address - Country:US
Practice Address - Phone:623-435-6303
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZRN044649163WS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WS0200XNursing Service ProvidersRegistered NurseSchool