Provider Demographics
NPI:1699492736
Name:IHLANG, KRISTINA KAY (APRN, CNP)
Entity type:Individual
Prefix:MRS
First Name:KRISTINA
Middle Name:KAY
Last Name:IHLANG
Suffix:
Gender:F
Credentials:APRN, CNP
Other - Prefix:MISS
Other - First Name:KRISTINA
Other - Middle Name:KAY
Other - Last Name:HERNANDEZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:17705 HUTCHINS DR STE 250
Mailing Address - Street 2:
Mailing Address - City:MINNETONKA
Mailing Address - State:MN
Mailing Address - Zip Code:55345-4103
Mailing Address - Country:US
Mailing Address - Phone:952-401-8300
Mailing Address - Fax:952-401-8242
Practice Address - Street 1:17705 HUTCHINS DR STE 250
Practice Address - Street 2:
Practice Address - City:MINNETONKA
Practice Address - State:MN
Practice Address - Zip Code:55345-4103
Practice Address - Country:US
Practice Address - Phone:952-401-8300
Practice Address - Fax:952-401-8242
Is Sole Proprietor?:No
Enumeration Date:2022-10-19
Last Update Date:2022-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN9631363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics