Individual
MRS. CHRISTINA E CUSTIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1501 S CLINTON ST, BALTIMORE, MD 21224-5730
(410) 763-6386
Mailing address
1501 S CLINTON ST, BALTIMORE, MD 21224-5730
(410) 763-6386
Taxonomy
Speciality
Code
Description
License number
State
163WC0400X
Case Management Registered Nurse
Primary
R225458
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
AAF4211
COMMERCIAL INSURANCE
—
Enumeration date
04/15/2022
Last updated
04/15/2022
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