Provider Demographics
NPI:1023792546
Name:JAKSTAS, CHRISTINA MARIE (HOME HEALTH AID)
Entity type:Individual
Prefix:
First Name:CHRISTINA
Middle Name:MARIE
Last Name:JAKSTAS
Suffix:
Gender:F
Credentials:HOME HEALTH AID
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4211 GLENBRIAR DR
Mailing Address - Street 2:
Mailing Address - City:BRUNSWICK
Mailing Address - State:OH
Mailing Address - Zip Code:44212-2197
Mailing Address - Country:US
Mailing Address - Phone:216-203-5246
Mailing Address - Fax:
Practice Address - Street 1:1685 STONYBROOK LN APT 319
Practice Address - Street 2:
Practice Address - City:BRUNSWICK
Practice Address - State:OH
Practice Address - Zip Code:44212-4520
Practice Address - Country:US
Practice Address - Phone:216-203-5246
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-06-14
Last Update Date:2023-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide