Individual provider Active NPI

Kristina Louissaint, NP

  • Nurse Practitioner
  • Stockbridge, GA
National Provider Identifier
1356814172
Registry record updated Nov 5, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
RN219024 Issued in GA
Practice address
290 Country Club Dr Ste 210
Stockbridge, GA 30281-9022
Phone
(770) 538-1723
Fax
(470) 202-9820
NPI assigned
Jan 3, 2019
Last updated
Nov 5, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 5, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X RN219024 GA Primary

Addresses

Primary practice location

290 Country Club Dr Ste 210
Stockbridge, GA 30281-9022

Mailing address

301 Mandy Rose Trce
Stockbridge, GA 30281-2353

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
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
RN219024GAMDNurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1546473600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730764800000",
    "number": "1356814172",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "301 MANDY ROSE TRCE",
            "city": "STOCKBRIDGE",
            "state": "GA",
            "postal_code": "302812353"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "290 COUNTRY CLUB DR STE 210",
            "city": "STOCKBRIDGE",
            "state": "GA",
            "postal_code": "302819022",
            "telephone_number": "770-538-1723",
            "fax_number": "470-202-9820"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOUISSAINT",
        "first_name": "KRISTINA",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-01-03",
        "last_updated": "2024-11-05",
        "certification_date": "2024-11-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "GA",
            "license": "RN219024",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Stockbridge, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 5, 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.