Provider Demographics
NPI:1083338784
Name:KALINAS, MICHELLE LORRAINE (RN,BSN,CCRC)
Entity Type:Individual
Prefix:
First Name:MICHELLE
Middle Name:LORRAINE
Last Name:KALINAS
Suffix:
Gender:F
Credentials:RN,BSN,CCRC
Other - Prefix:
Other - First Name:MICHELLE
Other - Middle Name:LORRAINE
Other - Last Name:HICKAM
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:RN,BSN,CCRC
Mailing Address - Street 1:9605 BISHOPSWOOD LN
Mailing Address - Street 2:
Mailing Address - City:PERRYSBURG
Mailing Address - State:OH
Mailing Address - Zip Code:43551-2620
Mailing Address - Country:US
Mailing Address - Phone:419-874-4989
Mailing Address - Fax:
Practice Address - Street 1:9605 BISHOPSWOOD LN
Practice Address - Street 2:
Practice Address - City:PERRYSBURG
Practice Address - State:OH
Practice Address - Zip Code:43551-2620
Practice Address - Country:US
Practice Address - Phone:419-874-4989
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-09-27
Last Update Date:2022-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRN.255692163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse