Provider Demographics
NPI:1194491027
Name:CALL, CHRISTINE V (REGISTERED NURSE)
Entity type:Individual
Prefix:MS
First Name:CHRISTINE
Middle Name:V
Last Name:CALL
Suffix:
Gender:F
Credentials:REGISTERED NURSE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22579 BLUEBIRD AVE
Mailing Address - Street 2:
Mailing Address - City:MATTAWAN
Mailing Address - State:MI
Mailing Address - Zip Code:49071-7752
Mailing Address - Country:US
Mailing Address - Phone:269-352-3356
Mailing Address - Fax:269-762-7989
Practice Address - Street 1:22579 BLUEBIRD AVE
Practice Address - Street 2:
Practice Address - City:MATTAWAN
Practice Address - State:MI
Practice Address - Zip Code:49071-7752
Practice Address - Country:US
Practice Address - Phone:269-352-3356
Practice Address - Fax:269-762-7989
Is Sole Proprietor?:Yes
Enumeration Date:2021-08-20
Last Update Date:2021-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704213977163WC0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC0400XNursing Service ProvidersRegistered NurseCase Management