Basic Information
| Provider Information | |||||||||
| NPI: | 1760038152 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | MACAULAY | ||||||||
| FirstName: | CHRISTINA | ||||||||
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| Credential: | PA-C | ||||||||
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| Mailing Information | |||||||||
| Address1: | 653 RUSTIC DR | ||||||||
| Address2: | |||||||||
| City: | KILLINGTON | ||||||||
| State: | VT | ||||||||
| PostalCode: | 057519477 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8022364485 | ||||||||
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| Practice Location | |||||||||
| Address1: | 181 MAIN ST | ||||||||
| Address2: | |||||||||
| City: | NORWAY | ||||||||
| State: | ME | ||||||||
| PostalCode: | 042685664 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2077435933 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 08/13/2019 | ||||||||
| LastUpdateDate: | 08/13/2019 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363AM0700X | PA1961 | ME | Y | Physician Assistants & Advanced Practice Nursing Providers | Physician Assistant | Medical |
No ID Information.