Provider Demographics
NPI:1326856964
Name:GOOD, CHRISTIE ROBIN
Entity type:Individual
Prefix:
First Name:CHRISTIE
Middle Name:ROBIN
Last Name:GOOD
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 1:1323 W 7TH ST
Mailing Address - Street 2:
Mailing Address - City:HASTINGS
Mailing Address - State:NE
Mailing Address - Zip Code:68901-4306
Mailing Address - Country:US
Mailing Address - Phone:402-705-7445
Mailing Address - Fax:
Practice Address - Street 1:1323 W 7TH ST
Practice Address - Street 2:
Practice Address - City:HASTINGS
Practice Address - State:NE
Practice Address - Zip Code:68901-4306
Practice Address - Country:US
Practice Address - Phone:402-705-7445
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-12-30
Last Update Date:2024-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant