Provider Demographics
NPI:1467859272
Name:HEALEY, CHRISTA (LPN)
Entity type:Individual
Prefix:
First Name:CHRISTA
Middle Name:
Last Name:HEALEY
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 1:3042 STATE ROUTE 125
Mailing Address - Street 2:
Mailing Address - City:HAMERSVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:45130-9708
Mailing Address - Country:US
Mailing Address - Phone:513-405-5690
Mailing Address - Fax:
Practice Address - Street 1:3042 STATE ROUTE 125
Practice Address - Street 2:
Practice Address - City:HAMERSVILLE
Practice Address - State:OH
Practice Address - Zip Code:45130-9708
Practice Address - Country:US
Practice Address - Phone:513-405-5690
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-11-21
Last Update Date:2014-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH156330164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse