Healthcare Provider Details

I. General information

NPI: 1508322413
Provider Name (Legal Business Name): CHRISTINA M LAMARRE RSST
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/15/2019
Last Update Date: 02/15/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

154 S RIPLEY BLVD
ALPENA MI
49707-3406
US

IV. Provider business mailing address

154 S RIPLEY BLVD
ALPENA MI
49707-3406
US

V. Phone/Fax

Practice location:
  • Phone: 989-356-6385
  • Fax: 989-356-4909
Mailing address:
  • Phone: 989-356-6385
  • Fax: 989-356-4909

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number6803087021
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: