Provider Demographics
NPI:1932459203
Name:CHRISTOPHER, RENEE CHRIS (LPN)
Entity Type:Individual
Prefix:
First Name:RENEE
Middle Name:CHRIS
Last Name:CHRISTOPHER
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 1:11919 228TH ST
Mailing Address - Street 2:
Mailing Address - City:CAMBRIA HEIGHTS
Mailing Address - State:NY
Mailing Address - Zip Code:11411-2133
Mailing Address - Country:US
Mailing Address - Phone:718-341-4293
Mailing Address - Fax:
Practice Address - Street 1:11919 228TH ST
Practice Address - Street 2:
Practice Address - City:CAMBRIA HEIGHTS
Practice Address - State:NY
Practice Address - Zip Code:11411-2133
Practice Address - Country:US
Practice Address - Phone:718-341-4293
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-09-14
Last Update Date:2012-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY10 309453164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse