Provider Demographics
NPI:1669940763
Name:AKADUH, CHRISTIE C
Entity type:Individual
Prefix:MRS
First Name:CHRISTIE
Middle Name:C
Last Name:AKADUH
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 1:2841 W WALNUT HILL LN APT 2068
Mailing Address - Street 2:
Mailing Address - City:IRVING
Mailing Address - State:TX
Mailing Address - Zip Code:75038-7381
Mailing Address - Country:US
Mailing Address - Phone:214-815-5577
Mailing Address - Fax:
Practice Address - Street 1:2841 W WALNUT HILL LN APT 2068
Practice Address - Street 2:
Practice Address - City:IRVING
Practice Address - State:TX
Practice Address - Zip Code:75038-7381
Practice Address - Country:US
Practice Address - Phone:214-815-5577
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-11-06
Last Update Date:2018-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX310727164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse