Provider Demographics
NPI:1255205076
Name:SELVIG, KRISTEN (LPN)
Entity type:Individual
Prefix:
First Name:KRISTEN
Middle Name:
Last Name:SELVIG
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:KRISTEN
Other - Middle Name:ALISON
Other - Last Name:WILHELM
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LPN
Mailing Address - Street 1:1106 W GREEN ST
Mailing Address - Street 2:
Mailing Address - City:HASTINGS
Mailing Address - State:MI
Mailing Address - Zip Code:49058-1721
Mailing Address - Country:US
Mailing Address - Phone:616-824-2366
Mailing Address - Fax:
Practice Address - Street 1:1106 W GREEN ST
Practice Address - Street 2:
Practice Address - City:HASTINGS
Practice Address - State:MI
Practice Address - Zip Code:49058-1721
Practice Address - Country:US
Practice Address - Phone:616-824-2366
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-10-03
Last Update Date:2025-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4703111420251J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251J00000XAgenciesNursing Care