Healthcare Provider Details

I. General information

NPI: 1386289924
Provider Name (Legal Business Name): CHRISTINA ESCO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/07/2019
Last Update Date: 11/07/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

607 HAMMOND PLZ
HOPKINSVILLE KY
42240-4971
US

IV. Provider business mailing address

PO BOX 614
HOPKINSVILLE KY
42241-0614
US

V. Phone/Fax

Practice location:
  • Phone: 270-885-9551
  • Fax: 270-885-5871
Mailing address:
  • Phone: 270-886-2205
  • Fax: 270-886-0392

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: