Provider Demographics
NPI:1639362205
Name:CHRISTOPHER, LISA AILEEN (LPN)
Entity Type:Individual
Prefix:MS
First Name:LISA
Middle Name:AILEEN
Last Name:CHRISTOPHER
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 1:84 WATER ST # A
Mailing Address - Street 2:
Mailing Address - City:NEWBURYPORT
Mailing Address - State:MA
Mailing Address - Zip Code:01950-2958
Mailing Address - Country:US
Mailing Address - Phone:978-462-1216
Mailing Address - Fax:978-462-1216
Practice Address - Street 1:84 WATER ST # A
Practice Address - Street 2:
Practice Address - City:NEWBURYPORT
Practice Address - State:MA
Practice Address - Zip Code:01950-2958
Practice Address - Country:US
Practice Address - Phone:978-462-1216
Practice Address - Fax:978-462-1216
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-27
Last Update Date:2007-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA32991164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse