Provider Demographics
NPI:1538405055
Name:CHRISTNER, SHIRLIE ANN (CNA)
Entity type:Individual
Prefix:
First Name:SHIRLIE
Middle Name:ANN
Last Name:CHRISTNER
Suffix:
Gender:F
Credentials:CNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:917 N 10TH AVE
Mailing Address - Street 2:
Mailing Address - City:BROKEN BOW
Mailing Address - State:NE
Mailing Address - Zip Code:68822-1226
Mailing Address - Country:US
Mailing Address - Phone:308-872-6273
Mailing Address - Fax:713-416-6587
Practice Address - Street 1:917 N 10TH AVE
Practice Address - Street 2:
Practice Address - City:BROKEN BOW
Practice Address - State:NE
Practice Address - Zip Code:68822-1226
Practice Address - Country:US
Practice Address - Phone:308-872-6273
Practice Address - Fax:713-416-6587
Is Sole Proprietor?:Yes
Enumeration Date:2013-01-02
Last Update Date:2013-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC08546343374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide