Provider Demographics
NPI:1023086667
Name:NEROS, CHRISTINA NICOLE (DC, MS)
Entity type:Individual
Prefix:DR
First Name:CHRISTINA
Middle Name:NICOLE
Last Name:NEROS
Suffix:
Gender:F
Credentials:DC, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 80708
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30366-0708
Mailing Address - Country:US
Mailing Address - Phone:517-974-1121
Mailing Address - Fax:888-671-5236
Practice Address - Street 1:1756 CENTURY BLVD NE STE A
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30345-3389
Practice Address - Country:US
Practice Address - Phone:404-638-6653
Practice Address - Fax:888-671-5236
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-09
Last Update Date:2010-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2301008885111N00000X
GACHIR008171111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MIOP14230001Medicare ID - Type Unspecified
MIV 04576Medicare UPIN