Provider Demographics
NPI:1801435540
Name:STOLTZENBURG, CHRISTY WAYNETTE
Entity type:Individual
Prefix:
First Name:CHRISTY
Middle Name:WAYNETTE
Last Name:STOLTZENBURG
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:CHRISTY
Other - Middle Name:WAYNETTE
Other - Last Name:CASH
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LVN
Mailing Address - Street 1:2305 BIRDCREEK TER
Mailing Address - Street 2:
Mailing Address - City:TEMPLE
Mailing Address - State:TX
Mailing Address - Zip Code:76502-1047
Mailing Address - Country:US
Mailing Address - Phone:254-771-0852
Mailing Address - Fax:
Practice Address - Street 1:2305 BIRDCREEK TER
Practice Address - Street 2:
Practice Address - City:TEMPLE
Practice Address - State:TX
Practice Address - Zip Code:76502-1047
Practice Address - Country:US
Practice Address - Phone:254-771-0852
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-12-28
Last Update Date:2023-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX351098164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse