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General NPI Number Information
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NPI Number | 1083290464
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Entity Type | Individual
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Provider Name | KRISTEN KAY MASSINGILL AGNP-C, PMHNP-BC
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Gender | Female
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Dates
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Enumeration Date | 03/24/2021
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Last Update Date | 03/02/2026
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Provider Practice Location Address
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Address Line | 2111 WOODWARD AVE
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City | DETROIT
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State | MI
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Zip | 48201-3421
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Country | US
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Telephone | 313-546-0900
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Fax |
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Provider Business Mailing Address
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Address Line | 238 EVANS GLEN TRL
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City | TIPTON
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State | MI
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Zip | 49287-9724
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Country | US
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Telephone | 517-260-2759
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number | APRN11035139
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | C-APN.0104493-C-NP
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License Number State | CO
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Taxonomy #3
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | APRN11035139
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License Number State | FL
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Taxonomy #4
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Taxonomy Code | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number | RN333246
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License Number State | GA
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Taxonomy #5
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | RN333246
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License Number State | GA
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Taxonomy #6
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Taxonomy Code | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number | APRN.CNP.0028580
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License Number State | OH
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Taxonomy #7
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Taxonomy Code | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number | 312084
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License Number State | NY
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Taxonomy #8
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Taxonomy Code | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number | 4704299129
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License Number State | MI
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Taxonomy #9
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 406783
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License Number State | NY
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Taxonomy #10
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | APRN.CNP.0028580
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License Number State | OH
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Taxonomy #11
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 26NJ15314800
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License Number State | NJ
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Taxonomy #12
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 4704299129
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License Number State | MI
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Taxonomy #13
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Taxonomy Code | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number | C-APN.0104493-C-NP
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License Number State | CO
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