Provider Demographics
NPI:1720252745
Name:HAKE, CHRISTINE PFALZ (MS)
Entity Type:Individual
Prefix:MS
First Name:CHRISTINE
Middle Name:PFALZ
Last Name:HAKE
Suffix:
Gender:F
Credentials: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 637273
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45263-7273
Mailing Address - Country:US
Mailing Address - Phone:812-842-4260
Mailing Address - Fax:812-602-3174
Practice Address - Street 1:4199 GATEWAY BLVD
Practice Address - Street 2:SUITE 3100
Practice Address - City:EVANSVILLE
Practice Address - State:IN
Practice Address - Zip Code:47630-8940
Practice Address - Country:US
Practice Address - Phone:812-842-4550
Practice Address - Fax:812-842-4549
Is Sole Proprietor?:No
Enumeration Date:2008-04-22
Last Update Date:2019-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO170300000X
170300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes170300000XOther Service ProvidersGenetic Counselor, MS