Provider Demographics
NPI:1932462710
Name:KONWINSKI, MARIE
Entity Type:Individual
Prefix:
First Name:MARIE
Middle Name:
Last Name:KONWINSKI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:MARIE
Other - Middle Name:
Other - Last Name:KONWINSKI
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:20712 ALGER ST
Mailing Address - Street 2:
Mailing Address - City:SAINT CLAIR SHORES
Mailing Address - State:MI
Mailing Address - Zip Code:48080-3712
Mailing Address - Country:US
Mailing Address - Phone:810-543-0003
Mailing Address - Fax:
Practice Address - Street 1:20712 ALGER ST
Practice Address - Street 2:
Practice Address - City:SAINT CLAIR SHORES
Practice Address - State:MI
Practice Address - Zip Code:48080-3712
Practice Address - Country:US
Practice Address - Phone:810-543-0003
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-06-18
Last Update Date:2013-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula