Healthcare Provider Details

I. General information

NPI: 1013164433
Provider Name (Legal Business Name): CHRISTINE ANN HURD-CLEM R.N., C.D.E.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/27/2008
Last Update Date: 08/27/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3416 COLUMBUS AVE
SANDUSKY OH
44870-5557
US

IV. Provider business mailing address

3416 COLUMBUS AVE
SANDUSKY OH
44870-5557
US

V. Phone/Fax

Practice location:
  • Phone: 419-625-7350
  • Fax: 419-625-6660
Mailing address:
  • Phone: 419-625-7350
  • Fax: 419-625-6660

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WD0400X
TaxonomyDiabetes Educator Registered Nurse
License NumberRN294435
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: