Provider Demographics
NPI:1649099110
Name:LEINGANG, KRISTIN (NNP-BC)
Entity type:Individual
Prefix:
First Name:KRISTIN
Middle Name:
Last Name:LEINGANG
Suffix:
Gender:F
Credentials:NNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8100 BEACON LOOP
Mailing Address - Street 2:
Mailing Address - City:BISMARCK
Mailing Address - State:ND
Mailing Address - Zip Code:58501-8617
Mailing Address - Country:US
Mailing Address - Phone:701-202-1473
Mailing Address - Fax:
Practice Address - Street 1:8100 BEACON LOOP
Practice Address - Street 2:
Practice Address - City:BISMARCK
Practice Address - State:ND
Practice Address - Zip Code:58501-8617
Practice Address - Country:US
Practice Address - Phone:701-202-1473
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-10-10
Last Update Date:2024-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ND104860728363LN0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LN0005XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerNeonatal, Critical Care