Individual
MISS CHRISTINA LEE BRANSCUM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3900 W BIG CHINO RD, PAULDEN, AZ 86334-3143
(928) 777-3280
Mailing address
3170 STILLWATER DR, PRESCOTT, AZ 86305-7151
(928) 777-3280
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
8761120
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
86-1025143
—
AZ
Enumeration date
03/19/2018
Last updated
03/20/2018
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