Provider Demographics
NPI:1790855310
Name:MALINKY, JEAN A (CNS)
Entity Type:Individual
Prefix:
First Name:JEAN
Middle Name:A
Last Name:MALINKY
Suffix:
Gender:F
Credentials:CNS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1299 OLENTANGY RIVER RD
Mailing Address - Street 2:#103
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43212-3135
Mailing Address - Country:US
Mailing Address - Phone:614-566-4278
Mailing Address - Fax:614-566-5424
Practice Address - Street 1:1299 OLENTANGY RIVER RD
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43212-3135
Practice Address - Country:US
Practice Address - Phone:614-566-4710
Practice Address - Fax:614-566-6846
Is Sole Proprietor?:No
Enumeration Date:2006-11-09
Last Update Date:2007-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHNS-06133163WP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHQ74600Medicare UPIN
OHMANS03761Medicare PIN