Mandalis-Defour, Christina L

Mandalis-Defour, Christina L is an individual health care provider with primary practice located at 15855 19 Mile Rd , Clinton Twp MI 48038-3504. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered, which is considered as her primary health care specialty. Mandalis-Defour, Christina L can be contacted via phone (586) 263-2370.

Contact Information

Primary practice address
15855 19 Mile Rd Clinton Twp MI 48038-3504
Phone: (586) 263-2370
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered 367500000X 4704215164 Michigan

Profile Details

NPI number 1477691277
LBN Legal business name Mandalis-Defour, Christina L
Credentials Certified Registered Nurse Anesthetist (CRNA)
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 2nd, 2007
Last updated Jun 1st, 2022 - about 2 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1477691277 NPPES
Michigan MEDICAID 4445020

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