Provider Demographics
NPI:1710570619
Name:CHRISTSON, HANIEL (RN, ADMINISTRATOR)
Entity Type:Individual
Prefix:MRS
First Name:HANIEL
Middle Name:
Last Name:CHRISTSON
Suffix:
Gender:F
Credentials:RN, ADMINISTRATOR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1327 EMPIRE CENTRAL DR STE 114
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75247-4018
Mailing Address - Country:US
Mailing Address - Phone:972-982-2227
Mailing Address - Fax:
Practice Address - Street 1:1327 EMPIRE CENTRAL DR STE 114
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75247-4018
Practice Address - Country:US
Practice Address - Phone:972-982-2227
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-02-11
Last Update Date:2021-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY1152899163WI0500X, 163WH0200X, 163WM0705X, 163WX0200X, 163WX1500X, 163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
No163WI0500XNursing Service ProvidersRegistered NurseInfusion Therapy
No163WH0200XNursing Service ProvidersRegistered NurseHome Health
No163WM0705XNursing Service ProvidersRegistered NurseMedical-Surgical
No163WX0200XNursing Service ProvidersRegistered NurseOncology
No163WX1500XNursing Service ProvidersRegistered NurseOstomy Care