Provider Demographics
NPI:1487405486
Name:GOLSON, CHRISTMAS DANITA
Entity type:Individual
Prefix:
First Name:CHRISTMAS
Middle Name:DANITA
Last Name:GOLSON
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 1:15035 EVANSTON ST
Mailing Address - Street 2:
Mailing Address - City:DETROIT
Mailing Address - State:MI
Mailing Address - Zip Code:48224-2803
Mailing Address - Country:US
Mailing Address - Phone:313-800-1279
Mailing Address - Fax:
Practice Address - Street 1:15035 EVANSTON ST
Practice Address - Street 2:
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48224-2803
Practice Address - Country:US
Practice Address - Phone:313-800-1279
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-03-28
Last Update Date:2024-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health