Kristy Joy Anderson

Primary specialty

Licensed Practical NurseTaxonomy code 164W00000X

License

4703110753 Issued in MI

Practice address

43825 Michigan Ave Ste 1
Canton, MI 48188-2551

Phone

(734) 937-3088

Fax

(734) 397-7044

NPI assigned

Jun 18, 2019

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1560816000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1560816000000",
    "number": "1124688569",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "43825 MICHIGAN AVE STE 1",
            "city": "CANTON",
            "state": "MI",
            "postal_code": "481882551"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "43825 MICHIGAN AVE STE 1",
            "city": "CANTON",
            "state": "MI",
            "postal_code": "481882551",
            "telephone_number": "734-937-3088",
            "fax_number": "734-397-7044"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANDERSON",
        "first_name": "KRISTY",
        "middle_name": "JOY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-06-18",
        "last_updated": "2019-06-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "MI",
            "license": "4703110753",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Amh Canton LLC
• Kothainayagi Anandhan
• Nancy Anastasi, M.D.
• Alissa Anastasio, DO
• Frank J Anderson, MD,MPH
• Margaret Therese Anderson, DDS, MS
• Ross William Anderson, D.D.S.
• Margie Clare Andreae, MD
• David J Andrews, DDS
• Angels on Guard Home Healthcare Services Inc.

• All providers in Canton, MI
• Licensed Practical Nurse in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 18, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.