Provider Demographics
NPI:1316336811
Name:LUNDINE, KRISTIN K (APNP)
Entity type:Individual
Prefix:MRS
First Name:KRISTIN
Middle Name:K
Last Name:LUNDINE
Suffix:
Gender:F
Credentials:APNP
Other - Prefix:MISS
Other - First Name:KRISTIN
Other - Middle Name:K
Other - Last Name:HILGEMANN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:APNP
Mailing Address - Street 1:122 E COLLEGE AVE
Mailing Address - Street 2:
Mailing Address - City:APPLETON
Mailing Address - State:WI
Mailing Address - Zip Code:54911-5794
Mailing Address - Country:US
Mailing Address - Phone:920-996-3264
Mailing Address - Fax:920-830-5970
Practice Address - Street 1:2701 E ENTERPRISE AVE
Practice Address - Street 2:
Practice Address - City:APPLETON
Practice Address - State:WI
Practice Address - Zip Code:54913-7729
Practice Address - Country:US
Practice Address - Phone:920-954-2551
Practice Address - Fax:920-954-2554
Is Sole Proprietor?:No
Enumeration Date:2015-01-21
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IAC138486363LP0200X
WI7183363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics