MEDICARE: CHRISTINA NEIRINCK FNP-BC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LP2300X	Primary Care Nurse Practitioner	4704286375	MI
2	363LF0000X	Family Nurse Practitioner	4704286375	MI

General Provider Information

NPI Number	:	1427600246
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHRISTINA NEIRINCK FNP-BC

Provider Business Mailing Address
First Line	:	1000 HARRINGTON ST
Second Line	:
City	:	MOUNT CLEMENS
State	:	MI
Zip	:	48043-2920
Country	:	US
Telephone Number	:	586-493-8142
Fax Number	:

Provider Business Practice Location Address
First Line	:	2401 ST ANTOINE ST
Second Line	:
City	:	DETROIT
State	:	MI
Zip	:	48201
Country	:	US
Telephone Number	:	313-745-3188
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/11/2019
Last Update Date	:	05/09/2023

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