Provider Demographics
NPI:1255836482
Name:HARWOOD, CHRISTINA ARLENE
Entity type:Individual
Prefix:
First Name:CHRISTINA
Middle Name:ARLENE
Last Name:HARWOOD
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 1:2500 COUNTY ROAD 1107A
Mailing Address - Street 2:
Mailing Address - City:CLEBURNE
Mailing Address - State:TX
Mailing Address - Zip Code:76031-0822
Mailing Address - Country:US
Mailing Address - Phone:817-240-8795
Mailing Address - Fax:
Practice Address - Street 1:2500 COUNTY ROAD 1107A
Practice Address - Street 2:
Practice Address - City:CLEBURNE
Practice Address - State:TX
Practice Address - Zip Code:76031-0822
Practice Address - Country:US
Practice Address - Phone:817-240-8795
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-03-28
Last Update Date:2018-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX124149164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse