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General NPI Number Information
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NPI Number | 1881557288
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Entity Type | Individual
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Provider Name | MS. NINA ETIENNE CHRISTMAS
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Gender | Female
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Dates
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Enumeration Date | 12/03/2025
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Last Update Date | 12/03/2025
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Provider Practice Location Address
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Address Line | 606 W ROOSEVELT RD
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City | CHICAGO
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State | IL
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Zip | 60607-4912
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Country | US
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Telephone | 872-262-6555
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Fax |
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Provider Business Mailing Address
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Address Line | 9520 MAYFIELD AVE APT N302
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City | OAK LAWN
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State | IL
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Zip | 60453-0002
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Country | US
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Telephone | 872-262-6555
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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 |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 171400000X
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Taxonomy Name | Health & Wellness Coach
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 171W00000X
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Taxonomy Name | Contractor
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | 012.007649
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License Number State | IL
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