Provider Demographics
NPI:1881043933
Name:ROMERO, CHRISTINA
Entity Type:Individual
Prefix:
First Name:CHRISTINA
Middle Name:
Last Name:ROMERO
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 1:105 PASEO DEL CANON W
Mailing Address - Street 2:STE A
Mailing Address - City:TAOS
Mailing Address - State:NM
Mailing Address - Zip Code:87571-6943
Mailing Address - Country:US
Mailing Address - Phone:575-758-5857
Mailing Address - Fax:
Practice Address - Street 1:105 PASEO DEL CANON W
Practice Address - Street 2:STE A
Practice Address - City:TAOS
Practice Address - State:NM
Practice Address - Zip Code:87571-6943
Practice Address - Country:US
Practice Address - Phone:575-758-5857
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-06-09
Last Update Date:2016-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMPT00006814183700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183700000XPharmacy Service ProvidersPharmacy Technician