Basic Information
Provider Information
NPI: 1609350438
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: HUG
FirstName: KRISTINA
MiddleName: MARIE
NamePrefix:  
NameSuffix:  
Credential: FNP-C
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 4000 WELLNESS DR
Address2:  
City: MIDLAND
State: MI
PostalCode: 486702000
CountryCode: US
TelephoneNumber: 8448321956
FaxNumber: 9896335241
Practice Location
Address1: 300 E WARWICK DR
Address2:  
City: ALMA
State: MI
PostalCode: 488011014
CountryCode: US
TelephoneNumber: 9898391644
FaxNumber: 9898393029
Other Information
ProviderEnumerationDate: 09/18/2018
LastUpdateDate: 10/14/2022
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 10/14/2022

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
363LF0000X4704294533MIY Physician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily

No ID Information.


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