Provider Demographics
NPI:1649366402
Name:DELKS, CHRISTINE (LPN)
Entity type:Individual
Prefix:
First Name:CHRISTINE
Middle Name:
Last Name:DELKS
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16183 PRINCETON ST
Mailing Address - Street 2:
Mailing Address - City:DETROIT
Mailing Address - State:MI
Mailing Address - Zip Code:48221-3141
Mailing Address - Country:US
Mailing Address - Phone:313-739-4239
Mailing Address - Fax:313-864-2154
Practice Address - Street 1:850 WHITMORE RD
Practice Address - Street 2:401
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48203-4048
Practice Address - Country:US
Practice Address - Phone:313-739-4239
Practice Address - Fax:313-842-9608
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-05
Last Update Date:2009-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4703090607164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse