Provider Demographics
NPI:1942613161
Name:MARINKOVIC, CHRISTINA
Entity Type:Individual
Prefix:MRS
First Name:CHRISTINA
Middle Name:
Last Name:MARINKOVIC
Suffix:
Gender:F
Credentials:
Other - Prefix:MISS
Other - First Name:CHRISTINA
Other - Middle Name:
Other - Last Name:PLYMALE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:905 BALFOUR ST
Mailing Address - Street 2:
Mailing Address - City:GROSSE POINTE PARK
Mailing Address - State:MI
Mailing Address - Zip Code:48230-1815
Mailing Address - Country:US
Mailing Address - Phone:337-534-9800
Mailing Address - Fax:
Practice Address - Street 1:905 BALFOUR ST
Practice Address - Street 2:
Practice Address - City:GROSSE POINTE PARK
Practice Address - State:MI
Practice Address - Zip Code:48230-1815
Practice Address - Country:US
Practice Address - Phone:337-534-9800
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-06-05
Last Update Date:2014-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704305144163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse