Provider Demographics
NPI:1982999348
Name:AYERS, CHRISTINE ANN (LPN)
Entity Type:Individual
Prefix:MRS
First Name:CHRISTINE
Middle Name:ANN
Last Name:AYERS
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:PO BOX 184
Mailing Address - Street 2:
Mailing Address - City:GORHAM
Mailing Address - State:NY
Mailing Address - Zip Code:14461-0184
Mailing Address - Country:US
Mailing Address - Phone:585-953-0381
Mailing Address - Fax:
Practice Address - Street 1:4502 ROBSON RD 184
Practice Address - Street 2:
Practice Address - City:GORHAM
Practice Address - State:NY
Practice Address - Zip Code:14461-0184
Practice Address - Country:US
Practice Address - Phone:585-953-0381
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-14
Last Update Date:2011-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY255904-1164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse