Provider Demographics
NPI:1952195133
Name:PALIWODA, KRISTINA MARIE (RN)
Entity type:Individual
Prefix:
First Name:KRISTINA
Middle Name:MARIE
Last Name:PALIWODA
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8255 SQUIREWOOD DR NE
Mailing Address - Street 2:
Mailing Address - City:COMSTOCK PARK
Mailing Address - State:MI
Mailing Address - Zip Code:49321-8297
Mailing Address - Country:US
Mailing Address - Phone:616-401-0836
Mailing Address - Fax:
Practice Address - Street 1:1131 IONIA AVE NW
Practice Address - Street 2:
Practice Address - City:GRAND RAPIDS
Practice Address - State:MI
Practice Address - Zip Code:49503-1020
Practice Address - Country:US
Practice Address - Phone:616-332-1126
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-04-04
Last Update Date:2025-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704304242163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse