Provider Demographics
NPI:1407262686
Name:KLIX, CHRISTINE A (RN)
Entity type:Individual
Prefix:
First Name:CHRISTINE
Middle Name:A
Last Name:KLIX
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6101 EAST MOLLOY ROAD
Mailing Address - Street 2:
Mailing Address - City:E. SYRACUSE
Mailing Address - State:NY
Mailing Address - Zip Code:13057
Mailing Address - Country:US
Mailing Address - Phone:315-432-5636
Mailing Address - Fax:315-432-0916
Practice Address - Street 1:4853 PEMBRIDGE CIR
Practice Address - Street 2:
Practice Address - City:SYRACUSE
Practice Address - State:NY
Practice Address - Zip Code:13215-1023
Practice Address - Country:US
Practice Address - Phone:314-468-1449
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-07-08
Last Update Date:2014-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY2513581163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse