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General NPI Number Information
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NPI Number | 1447731716
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Entity Type | Individual
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Provider Name | CHRISTINE ELLEN STEWART CRIF CRS
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Gender | Female
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Dates
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Enumeration Date | 08/24/2018
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Last Update Date | 07/25/2019
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Provider Practice Location Address
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Address Line | 1999 SPROUL RD STE 11
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City | BROOMALL
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State | PA
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Zip | 19008-3508
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Country | US
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Telephone | 610-325-0500
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Fax |
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Provider Business Mailing Address
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Address Line | 1999 SPROUL RD STE 11
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City | BROOMALL
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State | PA
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Zip | 19008-3508
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Country | US
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Telephone | 610-325-0500
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | 11689
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 175T00000X
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Taxonomy Name | Peer Specialist
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License Number | 11689
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License Number State | PA
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