Provider Demographics
NPI:1821486549
Name:STROBL, CHRISTINE CATHERINE (LPN)
Entity Type:Individual
Prefix:
First Name:CHRISTINE
Middle Name:CATHERINE
Last Name:STROBL
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 1:78 EAST COOKS POND ROAD
Mailing Address - Street 2:
Mailing Address - City:WEATHERSFIELD
Mailing Address - State:VT
Mailing Address - Zip Code:05156-9741
Mailing Address - Country:US
Mailing Address - Phone:802-885-1089
Mailing Address - Fax:
Practice Address - Street 1:105 CHESTER RD
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:VT
Practice Address - Zip Code:05156-2106
Practice Address - Country:US
Practice Address - Phone:802-885-5741
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-01-05
Last Update Date:2015-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT025.0097155164W00000X
NH016578-22164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
VT505648Medicaid