1912717463 NPI number — MRS. CHRISTINA JOY BUCHANAN CT

Table of content: MRS. CHRISTINA JOY BUCHANAN CT (NPI 1912717463)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1912717463 NPI number — MRS. CHRISTINA JOY BUCHANAN CT

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
BUCHANAN
Provider First Name:
CHRISTINA
Provider Middle Name:
JOY
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
CT
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
BROWN
Provider Other First Name:
CHRISTINA
Provider Other Middle Name:
JOY
Provider Other Name Prefix Text:
MRS.
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:
5

NPI Number Information

NPI Number:
1912717463
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
01/08/2025
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
72 RENEE DR
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
STRUTHERS
Provider Business Mailing Address State Name:
OH
Provider Business Mailing Address Postal Code:
44471-1516
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
864-704-6583
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
72 RENEE DR
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
STRUTHERS
Provider Business Practice Location Address State Name:
OH
Provider Business Practice Location Address Postal Code:
44471-1516
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
864-704-6583
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
01/08/2025

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 101YM0800X , with the licence number:  C.2406117-TRNE , registered in the state of OH ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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