Individual
KRISTEN LOGAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
100 MICHIGAN ST NE, GRAND RAPIDS, MI 49503-2560
(616) 364-4200
(616) 364-7347
Mailing address
3333 EVERGREEN DR NE, GRAND RAPIDS, MI 49525-9493
(616) 364-7347
(616) 364-7347
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
4704330416
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
360702001
—
TX
01
—
360702002
CSHCN
TX
Enumeration date
06/28/2016
Last updated
09/03/2024
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