Provider Demographics
NPI:1609846252
Name:FIFELSKI, KRISTI L (MSN RN CPNP)
Entity Type:Individual
Prefix:MRS
First Name:KRISTI
Middle Name:L
Last Name:FIFELSKI
Suffix:
Gender:F
Credentials:MSN RN CPNP
Other - Prefix:MS
Other - First Name:KRISTI
Other - Middle Name:L
Other - Last Name:ARNDT
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MSN RN CPNP
Mailing Address - Street 1:5629 STADIUM DR
Mailing Address - Street 2:SUITE A
Mailing Address - City:KALAMAZOO
Mailing Address - State:MI
Mailing Address - Zip Code:49009-1952
Mailing Address - Country:US
Mailing Address - Phone:269-372-1000
Mailing Address - Fax:269-372-0698
Practice Address - Street 1:5629 STADIUM DR
Practice Address - Street 2:SUITE A
Practice Address - City:KALAMAZOO
Practice Address - State:MI
Practice Address - Zip Code:49009-1952
Practice Address - Country:US
Practice Address - Phone:262-372-1000
Practice Address - Fax:269-372-0698
Is Sole Proprietor?:No
Enumeration Date:2006-01-25
Last Update Date:2020-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704236204363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI4827721Medicaid
MIM97850010Medicare PIN