Provider Demographics
NPI:1619955754
Name:ULRICH, CHRISTINE R (CNP)
Entity type:Individual
Prefix:
First Name:CHRISTINE
Middle Name:R
Last Name:ULRICH
Suffix:
Gender:F
Credentials:CNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1198 WESTWOOD DR STE F
Mailing Address - Street 2:
Mailing Address - City:VAN WERT
Mailing Address - State:OH
Mailing Address - Zip Code:45891-2478
Mailing Address - Country:US
Mailing Address - Phone:419-771-1640
Mailing Address - Fax:419-771-1641
Practice Address - Street 1:1198 WESTWOOD DR STE F
Practice Address - Street 2:
Practice Address - City:VAN WERT
Practice Address - State:OH
Practice Address - Zip Code:45891-2478
Practice Address - Country:US
Practice Address - Phone:419-771-1640
Practice Address - Fax:419-771-1641
Is Sole Proprietor?:No
Enumeration Date:2006-01-09
Last Update Date:2023-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHNP-08410363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH000000376143OtherANTHEM
OH000000377617OtherANTHEM
OHNP19251Medicare ID - Type Unspecified
OHP00261299Medicare ID - Type UnspecifiedRAILROAD MEDICARE
OHQ53330Medicare UPIN
OHNP19252Medicare ID - Type Unspecified