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General NPI Number Information
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NPI Number | 1194198143
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Entity Type | Organization
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Legal Business Name | CHRISTINA LAURY
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Dates
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Enumeration Date | 11/12/2015
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Last Update Date | 11/12/2015
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Provider Practice Location Address
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Address Line | 7666 CLOVERNOOK AVE
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City | CINCINNATI
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State | OH
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Zip | 45231-3506
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Country | US
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Telephone | 513-405-6031
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Fax |
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Provider Business Mailing Address
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Address Line | 7666 CLOVERNOOK AVE
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City | CINCINNATI
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State | OH
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Zip | 45231-3506
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Country | US
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Telephone | 513-405-6031
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Fax |
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Authorized Official
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Title or Position | LPN
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Name | MISS CHRISTINA AISHA LAURY
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Credential |
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Telephone | 513-405-6031
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 313M00000X
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Taxonomy Name | Nursing Facility/Intermediate Care Facility
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License Number | 127049
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License Number State | OH
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