Provider Demographics
NPI:1922642735
Name:GALZERANO, CHRISTINE BURKETT
Entity Type:Individual
Prefix:
First Name:CHRISTINE
Middle Name:BURKETT
Last Name:GALZERANO
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 1:135 JORDAN TRL
Mailing Address - Street 2:
Mailing Address - City:CORAPEAKE
Mailing Address - State:NC
Mailing Address - Zip Code:27926-9619
Mailing Address - Country:US
Mailing Address - Phone:757-692-9180
Mailing Address - Fax:
Practice Address - Street 1:135 JORDAN TRL
Practice Address - Street 2:
Practice Address - City:CORAPEAKE
Practice Address - State:NC
Practice Address - Zip Code:27926-9619
Practice Address - Country:US
Practice Address - Phone:757-692-9180
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-11-05
Last Update Date:2019-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC3747A0650X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747A0650XNursing Service Related ProvidersTechnicianAttendant Care Provider