Provider Demographics
NPI:1457420523
Name:LOGAN, CHRISTINA A (RN, CRNA)
Entity Type:Individual
Prefix:MISS
First Name:CHRISTINA
Middle Name:A
Last Name:LOGAN
Suffix:
Gender:F
Credentials:RN, CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2303 TULIK DR
Mailing Address - Street 2:
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99517-1132
Mailing Address - Country:US
Mailing Address - Phone:907-982-0513
Mailing Address - Fax:
Practice Address - Street 1:2303 TULIK DR
Practice Address - Street 2:
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99517-1132
Practice Address - Country:US
Practice Address - Phone:907-982-0513
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-06
Last Update Date:2013-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AKNUR R 20420367500000X
AK315367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered