Provider Demographics
NPI:1316489586
Name:AN, CHRISTINA VI (PHARMD)
Entity type:Individual
Prefix:
First Name:CHRISTINA
Middle Name:VI
Last Name:AN
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2907 CERRILLOS RD
Mailing Address - Street 2:
Mailing Address - City:SANTA FE
Mailing Address - State:NM
Mailing Address - Zip Code:87507-2310
Mailing Address - Country:US
Mailing Address - Phone:505-471-4660
Mailing Address - Fax:505-471-4659
Practice Address - Street 1:8011 VENTURA ST NE
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87109-6429
Practice Address - Country:US
Practice Address - Phone:505-217-2860
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-11-04
Last Update Date:2023-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMRP00008623183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist