Kristin Dykstra in Grand Rapids - Physician Assistant
Kristin Dykstra - NPI 1417122011
Kristin Dykstra is a Physician Assistant in Grand Rapids, Michigan. Kristin Dykstra practices all healthcare services and medical treatments related to Physician Assistant. The NPI Number for Kristin Dykstra is 1417122011. The last update date is 2021-10-01.
Kristin Dykstra's current location address is 4069 Lake Dr Se, Grand Rapids, Michigan. You can contact this provider via phone number 6162678700 and fax number 6162678247. The mailing address for Kristin Dykstra is 4069 Lake Dr Se, Grand Rapids, Michigan. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Kristin Dykstra |
|---|---|
| Address | 4069 Lake Dr Se, Grand Rapids, Michigan |
| Phone Number | 6162678700 |
| Fax Number | 6162678247 |
| Sole Proprietor | N |
| Credentials | PA-C |
NPI Number Detail
| NPI Number | 1417122011 |
|---|---|
| Provider Enumeration Date | 2008-04-24 |
| Last Updated Date | 2021-10-01 |
Provider Mailing Address Detail
| Address | 4069 Lake Dr Se |
|---|---|
| City | Grand Rapids |
| State | Michigan (MI) |
| Post Code | 495468816 |
| Phone Number | 6162678700 |
| Fax Number | 6162678247 |
Provider's Primary Taxonomy Detail
| Speciality | Physician Assistant |
|---|---|
| Taxonomy | 363A00000X |
| Licence No | 5601005234 |
|
Definition: A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perfor |
|
Post Comment/ Review Below
What is the unique 10-digit identification code issued to Kristin Dykstra by the Centers for Medicare & Medicaid Services?
The Kristin Dykstra has been assigned the NPI (National Provider Identifier) 1417122011 by the Centers for Medicare & Medicaid Services (CMS). This 10-digit code serves as a unique identifier for healthcare providers.
Can you provide the Kristin Dykstra's physical address?
The Kristin Dykstra is physically located at 4069 Lake Dr Se, in the city of Grand Rapids, MI, with the postal code 495468816.
What is Kristin Dykstra's primary field of medical specialization, and what is the corresponding taxonomy classification code for this area of expertise?
The primary field of medical specialization for Kristin Dykstra is Physician Assistant, and the taxonomy classification code that categorizes this area of expertise is 363A00000X.
On what date did the Kristin Dykstra receive its 1417122011 assignment from the Centers for Medicare & Medicaid Services?
The Kristin Dykstra was assigned its 1417122011 by the Centers for Medicare & Medicaid Services on 2008-04-24.
As of what date were the Kristin Dykstra's details last updated?
The information pertaining to the Kristin Dykstra, including its address, specialty, and other details, was most recently updated on 2021-10-01.