Provider Demographics
NPI:1801654439
Name:MICHELINI, GIANNA NIKKOL
Entity type:Individual
Prefix:
First Name:GIANNA
Middle Name:NIKKOL
Last Name:MICHELINI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:142 CONSTITUTION DR
Mailing Address - Street 2:
Mailing Address - City:EGG HARBOR TOWNSHIP
Mailing Address - State:NJ
Mailing Address - Zip Code:08234-5765
Mailing Address - Country:US
Mailing Address - Phone:609-206-6974
Mailing Address - Fax:
Practice Address - Street 1:142 CONSTITUTION DR
Practice Address - Street 2:
Practice Address - City:EGG HARBOR TOWNSHIP
Practice Address - State:NJ
Practice Address - Zip Code:08234-5765
Practice Address - Country:US
Practice Address - Phone:609-206-6974
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-03-08
Last Update Date:2024-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer