Provider Demographics
NPI:1548005564
Name:BRIGGS, KRISTYN NICOLE
Entity type:Individual
Prefix:
First Name:KRISTYN
Middle Name:NICOLE
Last Name:BRIGGS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:202 HIGH BANKS TRL
Mailing Address - Street 2:
Mailing Address - City:ORTONVILLE
Mailing Address - State:MI
Mailing Address - Zip Code:48462-9738
Mailing Address - Country:US
Mailing Address - Phone:248-410-1672
Mailing Address - Fax:
Practice Address - Street 1:202 HIGH BANKS TRL
Practice Address - Street 2:
Practice Address - City:ORTONVILLE
Practice Address - State:MI
Practice Address - Zip Code:48462-9738
Practice Address - Country:US
Practice Address - Phone:248-410-1672
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-07-01
Last Update Date:2024-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704331104163WE0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WE0003XNursing Service ProvidersRegistered NurseEmergency