Provider Demographics
NPI:1225657554
Name:MACKLIN, KRISTIE LYNN
Entity Type:Individual
Prefix:MRS
First Name:KRISTIE
Middle Name:LYNN
Last Name:MACKLIN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:27500 EMERY RD
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44128-5708
Mailing Address - Country:US
Mailing Address - Phone:216-496-7286
Mailing Address - Fax:
Practice Address - Street 1:27500 EMERY RD
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44128-5708
Practice Address - Country:US
Practice Address - Phone:216-496-7286
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-04-16
Last Update Date:2020-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide