Provider Demographics
NPI:1346965357
Name:CHRISTIANCY, CAITLYN RENEE
Entity Type:Individual
Prefix:
First Name:CAITLYN
Middle Name:RENEE
Last Name:CHRISTIANCY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:CAITLYN
Other - Middle Name:RENEE
Other - Last Name:HAUSSERMANN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1315 TIBBALS ST
Mailing Address - Street 2:
Mailing Address - City:HOLDREGE
Mailing Address - State:NE
Mailing Address - Zip Code:68949-1257
Mailing Address - Country:US
Mailing Address - Phone:308-995-6111
Mailing Address - Fax:
Practice Address - Street 1:1315 TIBBALS ST
Practice Address - Street 2:
Practice Address - City:HOLDREGE
Practice Address - State:NE
Practice Address - Zip Code:68949-1257
Practice Address - Country:US
Practice Address - Phone:308-995-6111
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-10-11
Last Update Date:2024-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant