Provider Demographics
NPI:1174289698
Name:MACIUSZKO, CHRISTINA ALEKSANDRA (RN, NBC-HWC)
Entity type:Individual
Prefix:DR
First Name:CHRISTINA
Middle Name:ALEKSANDRA
Last Name:MACIUSZKO
Suffix:
Gender:F
Credentials:RN, NBC-HWC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1733 EASTWICK LN
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37221-2532
Mailing Address - Country:US
Mailing Address - Phone:480-421-8323
Mailing Address - Fax:
Practice Address - Street 1:1733 EASTWICK LN
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37221-2532
Practice Address - Country:US
Practice Address - Phone:480-421-8323
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-11-09
Last Update Date:2021-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA-3273579171400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171400000XOther Service ProvidersHealth & Wellness Coach