Provider Demographics
NPI:1659031185
Name:MCCARTNEY, CHRISTINA L
Entity Type:Individual
Prefix:
First Name:CHRISTINA
Middle Name:L
Last Name:MCCARTNEY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:510 N JEFFERSON ST
Mailing Address - Street 2:
Mailing Address - City:ATHENS
Mailing Address - State:AL
Mailing Address - Zip Code:35611-1709
Mailing Address - Country:US
Mailing Address - Phone:423-285-0192
Mailing Address - Fax:
Practice Address - Street 1:510 N JEFFERSON ST
Practice Address - Street 2:
Practice Address - City:ATHENS
Practice Address - State:AL
Practice Address - Zip Code:35611-1709
Practice Address - Country:US
Practice Address - Phone:423-285-0192
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-12-24
Last Update Date:2021-12-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN8808183500000X
AL19744183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist