Provider Demographics
NPI:1942802459
Name:LADD, CHRISTIAN STARR (LPN)
Entity type:Individual
Prefix:MS
First Name:CHRISTIAN
Middle Name:STARR
Last Name:LADD
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 1:184 HUTCHINSON AVE
Mailing Address - Street 2:
Mailing Address - City:BUFFALO
Mailing Address - State:NY
Mailing Address - Zip Code:14215-2241
Mailing Address - Country:US
Mailing Address - Phone:716-228-1437
Mailing Address - Fax:
Practice Address - Street 1:184 HUTCHINSON AVE
Practice Address - Street 2:
Practice Address - City:BUFFALO
Practice Address - State:NY
Practice Address - Zip Code:14215-2241
Practice Address - Country:US
Practice Address - Phone:716-228-1437
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-11-10
Last Update Date:2020-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY325840-01164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse