Provider Demographics
NPI:1922631241
Name:CHANCE, CHRISTINA MICHELLE (LVN)
Entity Type:Individual
Prefix:
First Name:CHRISTINA
Middle Name:MICHELLE
Last Name:CHANCE
Suffix:
Gender:F
Credentials:LVN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:429 ROCK CREEK LN
Mailing Address - Street 2:
Mailing Address - City:STRAWN
Mailing Address - State:TX
Mailing Address - Zip Code:76475-1507
Mailing Address - Country:US
Mailing Address - Phone:940-659-8811
Mailing Address - Fax:
Practice Address - Street 1:429 ROCK CREEK LN
Practice Address - Street 2:
Practice Address - City:STRAWN
Practice Address - State:TX
Practice Address - Zip Code:76475-1507
Practice Address - Country:US
Practice Address - Phone:940-659-8811
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-02-14
Last Update Date:2020-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX349719164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse