Provider Demographics
NPI:1245599927
Name:FRENKEL, KARINA SEMENOVNA (NP-C)
Entity Type:Individual
Prefix:
First Name:KARINA
Middle Name:SEMENOVNA
Last Name:FRENKEL
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:29877 TELEGRAPH ROAD
Mailing Address - Street 2:SUITE 401
Mailing Address - City:SOUTHFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:48034-7661
Mailing Address - Country:US
Mailing Address - Phone:248-354-0730
Mailing Address - Fax:
Practice Address - Street 1:29877 TELEGRAPH ROAD
Practice Address - Street 2:SUITE 401
Practice Address - City:SOUTHFIELD
Practice Address - State:MI
Practice Address - Zip Code:48034-7661
Practice Address - Country:US
Practice Address - Phone:248-354-0730
Practice Address - Fax:248-354-1652
Is Sole Proprietor?:Yes
Enumeration Date:2012-05-15
Last Update Date:2021-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704232379363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI4704232379OtherLICENSE