Provider Demographics
NPI:1871806786
Name:MACHICAO, CHRISTINE C (FNP)
Entity type:Individual
Prefix:MS
First Name:CHRISTINE
Middle Name:C
Last Name:MACHICAO
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 505570
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63150-5570
Mailing Address - Country:US
Mailing Address - Phone:314-862-4050
Mailing Address - Fax:314-862-1141
Practice Address - Street 1:8888 LADUE RD
Practice Address - Street 2:STE 100
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63124-2326
Practice Address - Country:US
Practice Address - Phone:314-862-4050
Practice Address - Fax:314-862-1141
Is Sole Proprietor?:No
Enumeration Date:2010-07-20
Last Update Date:2024-04-25
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MO2001005535363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO420019031Medicaid