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NPI Code Detail

MEDICARE: MRS. CHRISTINA NICOLE STAPLETON MA

MEDICARE: MRS. CHRISTINA NICOLE STAPLETON MA
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YM0800XMental Health Counselor

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1790874774
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. CHRISTINA NICOLE STAPLETON MA
Provider Business Mailing Address
First Line : 3948 NEW VISION DR STE D
Second Line :
City : FORT WAYNE
State : IN
Zip : 46845-1721
Country : US
Telephone Number : 260-387-6340
Fax Number : 260-387-6984
Provider Business Practice Location Address
First Line : 3948 NEW VISION DR STE D
Second Line :
City : FORT WAYNE
State : IN
Zip : 46845-1721
Country : US
Telephone Number : 260-407-7285
Fax Number : 260-407-0094
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/11/2006
Last Update Date : 02/20/2012

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Directions to “ MRS. CHRISTINA NICOLE STAPLETON MA” Practice Location

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