Provider Demographics
NPI:1265936918
Name:STORIE, CHRISTIE L (LPN)
Entity type:Individual
Prefix:
First Name:CHRISTIE
Middle Name:L
Last Name:STORIE
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 1:950 MEADOW DR
Mailing Address - Street 2:
Mailing Address - City:MOUNT GILEAD
Mailing Address - State:OH
Mailing Address - Zip Code:43338-1389
Mailing Address - Country:US
Mailing Address - Phone:419-949-2000
Mailing Address - Fax:419-751-7322
Practice Address - Street 1:950 MEADOW DR STE A
Practice Address - Street 2:
Practice Address - City:MOUNT GILEAD
Practice Address - State:OH
Practice Address - Zip Code:43338-1389
Practice Address - Country:US
Practice Address - Phone:419-949-2000
Practice Address - Fax:419-751-7322
Is Sole Proprietor?:No
Enumeration Date:2018-03-19
Last Update Date:2018-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH142846164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse