Provider Demographics
NPI:1578139382
Name:DESTIN, MARIE GINETTE (PERSONAL CAREGIVER)
Entity Type:Individual
Prefix:MRS
First Name:MARIE
Middle Name:GINETTE
Last Name:DESTIN
Suffix:
Gender:F
Credentials:PERSONAL CAREGIVER
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:306 SE PINEWOOD TRL
Mailing Address - Street 2:
Mailing Address - City:PORT SAINT LUCIE
Mailing Address - State:FL
Mailing Address - Zip Code:34952-3519
Mailing Address - Country:US
Mailing Address - Phone:973-905-3387
Mailing Address - Fax:
Practice Address - Street 1:306 SE PINEWOOD TRL
Practice Address - Street 2:
Practice Address - City:PORT SAINT LUCIE
Practice Address - State:FL
Practice Address - Zip Code:34952-3519
Practice Address - Country:US
Practice Address - Phone:973-905-3387
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-06-02
Last Update Date:2021-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes372500000XNursing Service Related ProvidersChore ProviderGroup - Single Specialty