Provider Demographics
NPI:1215148879
Name:LANINGA, KRISTI J (RN, ANP-C)
Entity type:Individual
Prefix:
First Name:KRISTI
Middle Name:J
Last Name:LANINGA
Suffix:
Gender:F
Credentials:RN, ANP-C
Other - Prefix:
Other - First Name:KRISTI
Other - Middle Name:J
Other - Last Name:HOUCHIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN, AMP-C
Mailing Address - Street 1:PO BOX 1848
Mailing Address - Street 2:
Mailing Address - City:MUSKEGON
Mailing Address - State:MI
Mailing Address - Zip Code:49443-1848
Mailing Address - Country:US
Mailing Address - Phone:231-727-4444
Mailing Address - Fax:231-727-4571
Practice Address - Street 1:1150 E SHERMAN BLVD
Practice Address - Street 2:SUITE 1125
Practice Address - City:MUSKEGON
Practice Address - State:MI
Practice Address - Zip Code:49444-1871
Practice Address - Country:US
Practice Address - Phone:231-672-6740
Practice Address - Fax:231-672-6787
Is Sole Proprietor?:No
Enumeration Date:2007-05-25
Last Update Date:2021-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MIKH189648363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MIN33890OtherMEDICARE GROUP PTAN