Provider Demographics
NPI:1891307724
Name:EMERY, KRISTYN MARIE (RN)
Entity Type:Individual
Prefix:
First Name:KRISTYN
Middle Name:MARIE
Last Name:EMERY
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:KRISTYN
Other - Middle Name:MARIE
Other - Last Name:LAW
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:5191 PLAINS RD
Mailing Address - Street 2:
Mailing Address - City:ONONDAGA
Mailing Address - State:MI
Mailing Address - Zip Code:49264-9727
Mailing Address - Country:US
Mailing Address - Phone:517-525-6459
Mailing Address - Fax:
Practice Address - Street 1:2025 S WASHINGTON AVE STE 210
Practice Address - Street 2:
Practice Address - City:LANSING
Practice Address - State:MI
Practice Address - Zip Code:48910-0817
Practice Address - Country:US
Practice Address - Phone:517-371-1111
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-08-21
Last Update Date:2020-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704266471163WP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental Health