Provider Demographics
NPI:1730411745
Name:BEIREIS, CHRISTY MARIE (LPN)
Entity type:Individual
Prefix:
First Name:CHRISTY
Middle Name:MARIE
Last Name:BEIREIS
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 1:1596 S COUNTY ROAD 25A
Mailing Address - Street 2:
Mailing Address - City:TROY
Mailing Address - State:OH
Mailing Address - Zip Code:45373-4246
Mailing Address - Country:US
Mailing Address - Phone:937-417-4887
Mailing Address - Fax:
Practice Address - Street 1:1596 S COUNTY ROAD 25A
Practice Address - Street 2:
Practice Address - City:TROY
Practice Address - State:OH
Practice Address - Zip Code:45373-4246
Practice Address - Country:US
Practice Address - Phone:937-417-4887
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-02-02
Last Update Date:2010-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPN.138181-M-IV164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse