KRISTINE LYNN LIDBECK (NPI# 1578074654) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1578074654 |
| Entity Type | Individual |
| Full Name | KRISTINE LYNN LIDBECK |
| Credential | FNP-BC |
| Practice Address |
6105 Wilson Ave Sw Ste 2 Wyoming MI 49418-9714 |
| Mailing Address |
100 Michigan St Ne # Mc845 Grand Rapids MI 49503-2560 |
| Practice Telephone | 6164865299 |
| Enumeration Date | 2017-10-17 |
| Last Update Date | 2020-11-06 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
4704298187 | MI | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
6105 WILSON AVE SW STE 2 |
| City | WYOMING |
| State | MI |
| Zip Code | 49418-9714 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144799669 | Holly Cieslinski | Occupational Therapist | 3550 Fairlines Ave, Grandville, MI 49418 | 2018-11-14 |
| 1639664857 | Athletico Ltd | Physical Therapist | 3819 Rivertown Pkwy Sw Ste 100, Grandville, MI 49418 | 2018-06-29 |
| 1437651916 | Great Lakes Wellness Counseling LLC | Counselor | 2900 Wilson Ave Suite 110, Grandville, MI 49418 | 2018-03-01 |
| 1780111765 | Jenna Sargent | Nurse Practitioner | 2845 44th St Sw, Ste 200, Grandville, MI 49418 | 2017-05-22 |
| 1881132827 | Laura Elizabeth Ramaker | Specialist/Technologist | 2787 Pine Dunes Ct Sw, Wyoming, MI 49418 | 2017-02-10 |
| 1689026130 | Charles Unseld | Hearing Instrument Specialist | O-38 44th St Sw, Grandville, MI 49418 | 2016-07-08 |
| 1972989655 | Laci Dawn Johncock | Physical Therapy Assistant | 2786 56th Street, Wyoming, MI 49418 | 2015-08-05 |
| 1891178570 | Joshua Kolman | Pharmacist | 3434 Century Center Dr Sw, Grandville, MI 49418 | 2015-06-30 |
| 1710368782 | Tracie Medrano- Smith | Family Medicine | 4174 56th St Sw, Wyoming, MI 49418 | 2015-06-15 |
| 1124410808 | Kim Michelle Childress | Counselor | 4565 Wilson Ave Sw Ste 3a, Grandville, MI 49418 | 2015-03-04 |
| Find all providers in zip 49418 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700238730 | Kristen Denise Borchelt | Nurse Practitioner | 917 Oregon Trl, Wyoming, OH 45215-2535 | 2016-07-01 |
| 1205477924 | Samantha Mette | Nurse Practitioner | 5900 Byron Center Ave Sw, Wyoming, MI 49519-9606 | 2019-10-03 |
| 1518508704 | Rachel Kloosterman | Nurse Practitioner | 2215 44th St Sw, Wyoming, MI 49519-6439 | 2019-09-30 |
| 1063060028 | Dianne Teresa Brigalia | Nurse Practitioner | 5838 Metro Way Sw, Wyoming, MI 49519-9619 | 2019-09-03 |
| 1497309751 | Julie Ann Dragt | Nurse Practitioner | 5500 Clyde Park Ave Sw, Wyoming, MI 49509-9525 | 2019-07-25 |
| 1326691791 | Kory Allen Eastway | Nurse Practitioner | 5500 Clyde Park Ave Sw, Wyoming, MI 49509-9525 | 2019-07-24 |
| 1467005165 | Andrea Lynn Eastway | Nurse Practitioner | 5500 Clyde Park Ave Sw, Wyoming, MI 49509-9525 | 2019-07-22 |
| 1295393254 | Julie Anne Perski | Nurse Practitioner | 2221 Health Dr Sw Ste 2100, Wyoming, MI 49519-9650 | 2019-06-04 |
| 1740848316 | Bryan Douglas Brooks | Nurse Practitioner | 5900 Byron Center Ave Sw, Wyoming, MI 49519-9686 | 2019-05-30 |
| 1326500455 | Elizabeth Ann Klynstra | Nurse Practitioner | 5900 Byron Center Ave Sw, Wyoming, MI 49519-9606 | 2019-04-06 |
| Find all providers in WYOMING | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.