Kristina N Niehanke, NP

Primary specialty

Pediatric Nurse PractitionerTaxonomy code 363LP0200X

License

RN143057 Issued in GA

Practice address

105 W Cranford Ave
Valdosta, GA 31602-2930

Phone

(229) 247-7350

Fax

(229) 468-0042

NPI assigned

May 19, 2009

Last updated

Nov 6, 2024By the provider in NPPES

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

Credentials

Nurse Practitioner

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• South Central Primary Care Center, Inc

  dba Valdosta Children's Healthcare

  • Federally Qualified Health Center (FQHC)
  • Valdosta, GA
  • NPI 1174394423
  NPD (past)
• South Central Primary Care Center, Inc

  dba Kids Health Valdosta

  • Federally Qualified Health Center (FQHC)
  • Valdosta, GA
  • NPI 1528683885
  NPD (past)
• South Central Primary Care Center, Inc

  dba South Central Family Medicine

  • Federally Qualified Health Center (FQHC)
  • Pearson, GA
  • NPI 1558445742
  NPD (past)

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

{
    "created_epoch": "1242691200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730851200000",
    "number": "1306071444",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "105 W CRANFORD AVE",
            "city": "VALDOSTA",
            "state": "GA",
            "postal_code": "316022930",
            "telephone_number": "229-247-7350",
            "fax_number": "229-242-1730"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "105 W CRANFORD AVE",
            "city": "VALDOSTA",
            "state": "GA",
            "postal_code": "316022930",
            "telephone_number": "229-247-7350",
            "fax_number": "229-468-0042"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NIEHANKE",
        "first_name": "KRISTINA",
        "middle_name": "N",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-05-19",
        "last_updated": "2024-11-06",
        "certification_date": "2024-11-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "GA",
            "license": "RN143057",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Hoa Nguyen, PHD, LMFT
• Alicia Nicholson
• Lyssa Nickle, L.C.S.W.
• Nicole W Nimmo LPC LLC
• Fnu Nida Sayeed
• Alesia Rochale Traeye Nix, DNP, FNP-C
• Haley Nix, NP-C
• Katelyn Noles, LMFT
• Francis J Norman Jr., CRNA
• Katie Repko Norris, DPT

• Pediatric Nurse Practitioner in Valdosta, GA
• Providers in Valdosta, GA by specialty
• Pediatric Nurse Practitioner in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 6, 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.