Provider Demographics
NPI:1396012332
Name:LOMBARD, CHRISTOPHER F (RN)
Entity type:Individual
Prefix:
First Name:CHRISTOPHER
Middle Name:F
Last Name:LOMBARD
Suffix:
Gender:M
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4489 HOAGLAND BLACKSTUB RD
Mailing Address - Street 2:
Mailing Address - City:CORTLAND
Mailing Address - State:OH
Mailing Address - Zip Code:44410-9573
Mailing Address - Country:US
Mailing Address - Phone:330-501-8588
Mailing Address - Fax:330-306-5123
Practice Address - Street 1:4489 HOAGLAND BLACKSTUB RD
Practice Address - Street 2:
Practice Address - City:CORTLAND
Practice Address - State:OH
Practice Address - Zip Code:44410-9573
Practice Address - Country:US
Practice Address - Phone:330-501-8588
Practice Address - Fax:330-306-5123
Is Sole Proprietor?:Yes
Enumeration Date:2011-11-18
Last Update Date:2011-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRN332981374700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374700000XNursing Service Related ProvidersTechnician
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHRN332981OtherRN LICENSE