Provider Demographics
NPI:1447130885
Name:KETCHUM, CHRISTINA LOVE (LPN)
Entity type:Individual
Prefix:
First Name:CHRISTINA
Middle Name:LOVE
Last Name:KETCHUM
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 106
Mailing Address - Street 2:
Mailing Address - City:WINONA
Mailing Address - State:OH
Mailing Address - Zip Code:44493-0106
Mailing Address - Country:US
Mailing Address - Phone:330-429-3104
Mailing Address - Fax:
Practice Address - Street 1:PO BOX 106
Practice Address - Street 2:31914 WINONA RD P.O BOX 106
Practice Address - City:WINONA
Practice Address - State:OH
Practice Address - Zip Code:44493-0106
Practice Address - Country:US
Practice Address - Phone:330-429-3104
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-09-05
Last Update Date:2025-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747A0650XNursing Service Related ProvidersTechnicianAttendant Care Provider