Healthcare Provider Details

I. General information

NPI: 1225600265
Provider Name (Legal Business Name): CHRISTINE IRENE LAMBERT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/10/2021
Last Update Date: 11/14/2023
Certification Date: 11/14/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6131 US HIGHWAY 6
PORTAGE IN
46368-5058
US

IV. Provider business mailing address

6131 US HIGHWAY 6
PORTAGE IN
46368-5058
US

V. Phone/Fax

Practice location:
  • Phone: 219-841-9788
  • Fax:
Mailing address:
  • Phone: 219-841-9788
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberF06212480
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: