Provider Demographics
NPI:1770802704
Name:PELTIER, CHRISTINA MARIE (FNP)
Entity type:Individual
Prefix:MRS
First Name:CHRISTINA
Middle Name:MARIE
Last Name:PELTIER
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:CHRISTINA
Other - Middle Name:MARIE
Other - Last Name:CHORBA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:885 SHADY LN
Mailing Address - Street 2:
Mailing Address - City:TRAVERSE CITY
Mailing Address - State:MI
Mailing Address - Zip Code:49686-4367
Mailing Address - Country:US
Mailing Address - Phone:517-960-4193
Mailing Address - Fax:
Practice Address - Street 1:2950 LAFRANIER RD
Practice Address - Street 2:
Practice Address - City:TRAVERSE CITY
Practice Address - State:MI
Practice Address - Zip Code:49686-4918
Practice Address - Country:US
Practice Address - Phone:312-866-8274
Practice Address - Fax:231-346-6027
Is Sole Proprietor?:Yes
Enumeration Date:2010-06-01
Last Update Date:2023-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704306369163W00000X
MI385H00000X
MI2020114244363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No163W00000XNursing Service ProvidersRegistered Nurse
No385H00000XRespite Care FacilityRespite Care