Healthcare Provider Details

I. General information

NPI: 1487299152
Provider Name (Legal Business Name): CHRISTOPHER CAREY NOORDA
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/16/2019
Last Update Date: 12/11/2025
Certification Date: 12/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

607 GOLDEN RIDGE CT
CRANBERRY TOWNSHIP PA
16066-4825
US

IV. Provider business mailing address

PO BOX 840853
DALLAS TX
75284-4825
US

V. Phone/Fax

Practice location:
  • Phone: 480-685-6690
  • Fax:
Mailing address:
  • Phone: 972-233-1999
  • Fax: 972-233-3666

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number1066680
License Number StateTX
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN714175
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: