Provider Demographics
NPI:1295587830
Name:DIMICHELE, CHRISTINA LYNN
Entity type:Individual
Prefix:
First Name:CHRISTINA
Middle Name:LYNN
Last Name:DIMICHELE
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 1:5537 LOMA LINDA LN NE STE A
Mailing Address - Street 2:
Mailing Address - City:CANTON
Mailing Address - State:OH
Mailing Address - Zip Code:44721-3272
Mailing Address - Country:US
Mailing Address - Phone:330-949-0051
Mailing Address - Fax:
Practice Address - Street 1:304 15TH ST NE STE A
Practice Address - Street 2:
Practice Address - City:CANTON
Practice Address - State:OH
Practice Address - Zip Code:44714-2523
Practice Address - Country:US
Practice Address - Phone:330-949-0051
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-04-05
Last Update Date:2024-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide