Provider Demographics
NPI:1538941612
Name:CHRISTIAN, MACI ELYZA (CNA,HHA)
Entity type:Individual
Prefix:MRS
First Name:MACI
Middle Name:ELYZA
Last Name:CHRISTIAN
Suffix:
Gender:F
Credentials:CNA,HHA
Other - Prefix:
Other - First Name:MACI
Other - Middle Name:ELYZA
Other - Last Name:CHRISTIAN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:CNA,HHA
Mailing Address - Street 1:1814 TRADITIONS CT
Mailing Address - Street 2:
Mailing Address - City:FRANKLIN
Mailing Address - State:IN
Mailing Address - Zip Code:46131-7541
Mailing Address - Country:US
Mailing Address - Phone:317-361-2419
Mailing Address - Fax:
Practice Address - Street 1:1814 TRADITIONS CT
Practice Address - Street 2:
Practice Address - City:FRANKLIN
Practice Address - State:IN
Practice Address - Zip Code:46131-7541
Practice Address - Country:US
Practice Address - Phone:317-361-2419
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-10-16
Last Update Date:2023-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
INCNA1906410376K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376K00000XNursing Service Related ProvidersNurse's Aide