Provider Demographics
NPI:1760533640
Name:TOMASZEWSKI, CHRISTINE ELIZABETH (NURSE PRACTITIONER)
Entity Type:Individual
Prefix:MS
First Name:CHRISTINE
Middle Name:ELIZABETH
Last Name:TOMASZEWSKI
Suffix:
Gender:F
Credentials:NURSE PRACTITIONER
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4100 RIVER RD
Mailing Address - Street 2:ST. JOHN RIVER DISTRICT HOSPITAL
Mailing Address - City:EAST CHINA
Mailing Address - State:MI
Mailing Address - Zip Code:48054-2909
Mailing Address - Country:US
Mailing Address - Phone:810-329-7100
Mailing Address - Fax:
Practice Address - Street 1:4100 RIVER RD
Practice Address - Street 2:ST. JOHN RIVER DISTRICT HOSPITAL
Practice Address - City:EAST CHINA
Practice Address - State:MI
Practice Address - Zip Code:48054-2909
Practice Address - Country:US
Practice Address - Phone:810-329-7100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-16
Last Update Date:2011-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704195489363LA2100X, 363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI1760533640Medicaid
MI1750334405OtherPHYSICIAN HEALTHCARE NETWORK, PC
MI1750334405OtherPHYSICIAN HEALTHCARE NETWORK, PC