Provider Demographics
NPI:1891457438
Name:CLARKE-STREETE, CHRISTINA (LPN)
Entity Type:Individual
Prefix:
First Name:CHRISTINA
Middle Name:
Last Name:CLARKE-STREETE
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 1:10 E BROADWAY
Mailing Address - Street 2:
Mailing Address - City:TAUNTON
Mailing Address - State:MA
Mailing Address - Zip Code:02780-2628
Mailing Address - Country:US
Mailing Address - Phone:954-515-8999
Mailing Address - Fax:
Practice Address - Street 1:10 E BROADWAY
Practice Address - Street 2:
Practice Address - City:TAUNTON
Practice Address - State:MA
Practice Address - Zip Code:02780-2628
Practice Address - Country:US
Practice Address - Phone:954-515-8999
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-10-11
Last Update Date:2021-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA97301164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse