Provider Demographics
NPI:1982566428
Name:ERVIN, CHRISTINA TIARA (DC)
Entity type:Individual
Prefix:DR
First Name:CHRISTINA
Middle Name:TIARA
Last Name:ERVIN
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1146 E 77TH ST
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64131-1935
Mailing Address - Country:US
Mailing Address - Phone:918-214-9057
Mailing Address - Fax:
Practice Address - Street 1:9154 W 135TH ST
Practice Address - Street 2:
Practice Address - City:OVERLAND PARK
Practice Address - State:KS
Practice Address - Zip Code:66221-2044
Practice Address - Country:US
Practice Address - Phone:913-851-5188
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-12-02
Last Update Date:2025-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS01-06435111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor