Healthcare Provider Details

I. General information

NPI: 1871289306
Provider Name (Legal Business Name): CHRISTINA HARD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: CHRISTINA BOVE

II. Dates (important events)

Enumeration Date: 04/17/2023
Last Update Date: 08/28/2023
Certification Date: 08/26/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1909 CUBA AVE STE 5
ALAMOGORDO NM
88310-5646
US

IV. Provider business mailing address

1909 CUBA AVE STE 5
ALAMOGORDO NM
88310-5646
US

V. Phone/Fax

Practice location:
  • Phone: 575-489-4616
  • Fax: 575-489-4619
Mailing address:
  • Phone: 575-489-4616
  • Fax: 575-489-4619

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: