Provider Demographics
NPI:1689189839
Name:CHRISTIAN, ROSE-CLAIRE
Entity Type:Individual
Prefix:
First Name:ROSE-CLAIRE
Middle Name:
Last Name:CHRISTIAN
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 1:1860 MOGRA CIR NE APT 228
Mailing Address - Street 2:
Mailing Address - City:PALM BAY
Mailing Address - State:FL
Mailing Address - Zip Code:32905-3061
Mailing Address - Country:US
Mailing Address - Phone:340-332-2665
Mailing Address - Fax:
Practice Address - Street 1:1860 MOGRA CIR NE APT 228
Practice Address - Street 2:
Practice Address - City:PALM BAY
Practice Address - State:FL
Practice Address - Zip Code:32905-3061
Practice Address - Country:US
Practice Address - Phone:340-332-2665
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-12-11
Last Update Date:2017-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist