Provider Demographics
NPI:1255756904
Name:MCKINLEY, CHRISTINA (REGISTERED NURSE)
Entity type:Individual
Prefix:MRS
First Name:CHRISTINA
Middle Name:
Last Name:MCKINLEY
Suffix:
Gender:F
Credentials:REGISTERED NURSE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1167 HOLIDAY STREET
Mailing Address - Street 2:
Mailing Address - City:MUSKEGON
Mailing Address - State:MI
Mailing Address - Zip Code:49442
Mailing Address - Country:US
Mailing Address - Phone:616-862-4656
Mailing Address - Fax:616-243-2302
Practice Address - Street 1:1167 HOLIDAY ST
Practice Address - Street 2:
Practice Address - City:MUSKEGON
Practice Address - State:MI
Practice Address - Zip Code:49442-4905
Practice Address - Country:US
Practice Address - Phone:616-570-4144
Practice Address - Fax:616-243-2302
Is Sole Proprietor?:Yes
Enumeration Date:2014-03-04
Last Update Date:2015-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704256018163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse