Provider Demographics
NPI:1710021746
Name:MARKULIK, CHRISTINE R (LPN)
Entity type:Individual
Prefix:
First Name:CHRISTINE
Middle Name:R
Last Name:MARKULIK
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2815 MARIONCLIFF DR
Mailing Address - Street 2:
Mailing Address - City:PARMA
Mailing Address - State:OH
Mailing Address - Zip Code:44134-3451
Mailing Address - Country:US
Mailing Address - Phone:440-342-0149
Mailing Address - Fax:
Practice Address - Street 1:2815 MARIONCLIFF DR
Practice Address - Street 2:
Practice Address - City:PARMA
Practice Address - State:OH
Practice Address - Zip Code:44134-3451
Practice Address - Country:US
Practice Address - Phone:440-342-0149
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-15
Last Update Date:2016-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH095124164W00000X
374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse
No374U00000XNursing Service Related ProvidersHome Health Aide
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2425843Medicaid