Provider Demographics
NPI:1447090675
Name:MAKLE, KRYSTAL JOY
Entity type:Individual
Prefix:
First Name:KRYSTAL
Middle Name:JOY
Last Name:MAKLE
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 1:4020 MINNESOTA AVE NE APT 316
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20019-3525
Mailing Address - Country:US
Mailing Address - Phone:202-923-0562
Mailing Address - Fax:
Practice Address - Street 1:5201 CONNECTICUT AVE NW APT 409
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20015-1858
Practice Address - Country:US
Practice Address - Phone:202-770-5918
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-05-27
Last Update Date:2024-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant