Provider Demographics
NPI:1962202218
Name:ALSIDEZ, CHRISTY A
Entity type:Individual
Prefix:
First Name:CHRISTY
Middle Name:A
Last Name:ALSIDEZ
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1502 9TH AVE
Mailing Address - Street 2:
Mailing Address - City:SCOTTSBLUFF
Mailing Address - State:NE
Mailing Address - Zip Code:69361-3221
Mailing Address - Country:US
Mailing Address - Phone:308-631-7471
Mailing Address - Fax:
Practice Address - Street 1:1502 9TH AVE
Practice Address - Street 2:
Practice Address - City:SCOTTSBLUFF
Practice Address - State:NE
Practice Address - Zip Code:69361-3221
Practice Address - Country:US
Practice Address - Phone:308-631-7471
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-03-17
Last Update Date:2025-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes372600000XNursing Service Related ProvidersAdult Companion