Individual provider Active NPI

Krista Pallas, RN

  • Registered Nurse
  • East Lansing, MI
National Provider Identifier
1174362131
Registry record updated May 21, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
4704357990 Issued in MI
Practice address
1355 Bogue St
East Lansing, MI 48824-6207
Phone
(517) 355-1855
NPI assigned
May 21, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 21, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 4704357990 MI Primary

Addresses

Primary practice location

1355 Bogue St
East Lansing, MI 48824-6207

Mailing address

2495 Manchester Rd
Birmingham, MI 48009-5896
Phone (248) 953-9067

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
4704357990MIMDRegistered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1716249600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1716249600000",
    "number": "1174362131",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2495 MANCHESTER RD",
            "city": "BIRMINGHAM",
            "state": "MI",
            "postal_code": "480095896",
            "telephone_number": "248-953-9067"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1355 BOGUE ST",
            "city": "EAST LANSING",
            "state": "MI",
            "postal_code": "488246207",
            "telephone_number": "517-355-1855"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PALLAS",
        "first_name": "KRISTA",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-05-21",
        "last_updated": "2024-05-21",
        "certification_date": "2024-05-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MI",
            "license": "4704357990",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in East Lansing, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 21, 2024; 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.