Provider Demographics
NPI:1770337370
Name:STEADMAN, MACAIYLA GABRIELLE
Entity type:Individual
Prefix:
First Name:MACAIYLA
Middle Name:GABRIELLE
Last Name:STEADMAN
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 1:715 HARNESS CT
Mailing Address - Street 2:
Mailing Address - City:LITHONIA
Mailing Address - State:GA
Mailing Address - Zip Code:30058-5801
Mailing Address - Country:US
Mailing Address - Phone:678-684-8605
Mailing Address - Fax:
Practice Address - Street 1:715 HARNESS CT
Practice Address - Street 2:
Practice Address - City:LITHONIA
Practice Address - State:GA
Practice Address - Zip Code:30058-5801
Practice Address - Country:US
Practice Address - Phone:678-684-8605
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-04-11
Last Update Date:2024-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide