Provider Demographics
NPI:1023886918
Name:LARDAS, CHRISTALA GENEE
Entity type:Individual
Prefix:MRS
First Name:CHRISTALA
Middle Name:GENEE
Last Name:LARDAS
Suffix:
Gender:F
Credentials:
Other - Prefix:MRS
Other - First Name:CHRISTALA
Other - Middle Name:GENEE
Other - Last Name:LARDAS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MSN APRN FNP-BC
Mailing Address - Street 1:13505 TRAIL MEADOW LN
Mailing Address - Street 2:
Mailing Address - City:ROSHARON
Mailing Address - State:TX
Mailing Address - Zip Code:77583-2170
Mailing Address - Country:US
Mailing Address - Phone:713-419-1659
Mailing Address - Fax:
Practice Address - Street 1:9201 E MOUNTAIN VIEW RD STE 220
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85258-5172
Practice Address - Country:US
Practice Address - Phone:877-564-3627
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-12-19
Last Update Date:2023-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1143322363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care