Provider Demographics
NPI:1669639944
Name:CHRISTIAN, AMY L
Entity Type:Individual
Prefix:MS
First Name:AMY
Middle Name:L
Last Name:CHRISTIAN
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 1:27235 BAGLEY RD
Mailing Address - Street 2:
Mailing Address - City:OLMSTED FALLS
Mailing Address - State:OH
Mailing Address - Zip Code:44138-1001
Mailing Address - Country:US
Mailing Address - Phone:440-477-3198
Mailing Address - Fax:
Practice Address - Street 1:27235 BAGLEY RD
Practice Address - Street 2:
Practice Address - City:OLMSTED FALLS
Practice Address - State:OH
Practice Address - Zip Code:44138-1001
Practice Address - Country:US
Practice Address - Phone:440-477-3198
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-22
Last Update Date:2008-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2711373Medicaid