Provider Demographics
NPI:1457170383
Name:CARR, MAKALA CHRISTINE
Entity type:Individual
Prefix:
First Name:MAKALA
Middle Name:CHRISTINE
Last Name:CARR
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 1:18161 144TH AVE
Mailing Address - Street 2:
Mailing Address - City:SPRING LAKE
Mailing Address - State:MI
Mailing Address - Zip Code:49456-9135
Mailing Address - Country:US
Mailing Address - Phone:269-330-7296
Mailing Address - Fax:
Practice Address - Street 1:18161 144TH AVE
Practice Address - Street 2:
Practice Address - City:SPRING LAKE
Practice Address - State:MI
Practice Address - Zip Code:49456-9135
Practice Address - Country:US
Practice Address - Phone:269-330-7296
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-10-08
Last Update Date:2024-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care