Provider Demographics
NPI:1861890444
Name:JAMBORSKI, CHRISTINE
Entity type:Individual
Prefix:
First Name:CHRISTINE
Middle Name:
Last Name:JAMBORSKI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14030 N. EL PUEBLO BLVD
Mailing Address - Street 2:EL PUEBLO ASSISTED LIVING
Mailing Address - City:FOUNTAIN HILLS
Mailing Address - State:AZ
Mailing Address - Zip Code:85268-3211
Mailing Address - Country:US
Mailing Address - Phone:480-219-2363
Mailing Address - Fax:480-219-2363
Practice Address - Street 1:14030 N. EL PUEBLO BLVD
Practice Address - Street 2:EL PUEBLO ASSISTED LIVING
Practice Address - City:FOUNTAIN HILLS
Practice Address - State:AZ
Practice Address - Zip Code:85268-3211
Practice Address - Country:US
Practice Address - Phone:480-219-2363
Practice Address - Fax:480-219-2363
Is Sole Proprietor?:Yes
Enumeration Date:2014-12-12
Last Update Date:2014-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZAL8691H171M00000X
AZ10397376G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376G00000XNursing Service Related ProvidersNursing Home Administrator
No171M00000XOther Service ProvidersCase Manager/Care Coordinator