Provider Demographics
NPI:1891011557
Name:KYSER-CARTER, CHRISTINA J
Entity Type:Individual
Prefix:
First Name:CHRISTINA
Middle Name:J
Last Name:KYSER-CARTER
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 1:5723 RAMBO LN
Mailing Address - Street 2:
Mailing Address - City:TOLEDO
Mailing Address - State:OH
Mailing Address - Zip Code:43623-1823
Mailing Address - Country:US
Mailing Address - Phone:567-277-3197
Mailing Address - Fax:
Practice Address - Street 1:5723 RAMBO LN
Practice Address - Street 2:
Practice Address - City:TOLEDO
Practice Address - State:OH
Practice Address - Zip Code:43623-1823
Practice Address - Country:US
Practice Address - Phone:567-277-3197
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-04-20
Last Update Date:2010-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPN 137605 - M - IV164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse