Provider Demographics
NPI:1275776130
Name:CADY, CHRISTLAEN ELIZABETH (NP)
Entity Type:Individual
Prefix:MRS
First Name:CHRISTLAEN
Middle Name:ELIZABETH
Last Name:CADY
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14125 BROWN BRIDGE RD
Mailing Address - Street 2:
Mailing Address - City:COVINGTON
Mailing Address - State:GA
Mailing Address - Zip Code:30016-4124
Mailing Address - Country:US
Mailing Address - Phone:770-312-1279
Mailing Address - Fax:
Practice Address - Street 1:402 N 5TH AVE
Practice Address - Street 2:
Practice Address - City:YAKIMA
Practice Address - State:WA
Practice Address - Zip Code:98902-2107
Practice Address - Country:US
Practice Address - Phone:770-312-1279
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-04-08
Last Update Date:2024-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN100014363LF0000X
WARN61429848363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily