Individual
CHRISTY A IDLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN, MSN
Contact information
Practice address
1540 LAKE LANSING RD, SUITE 102, LANSING, MI 48912-3756
(517) 913-3810
(517) 913-3811
Mailing address
1540 LAKE LANSING RD, SUITE 102, LANSING, MI 48912-3756
(517) 913-3810
(517) 913-3811
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
4704214994
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0N55170015
MEDICARE PLUS BLUE
MI
01
—
1046484
MCLAREN HEALTH ADVANTAGE
MI
05
—
114837094
—
MI
01
—
5008707670
BLUE CROSS BLUE SHIELD OF MICHIGAN
MI
05
—
5195263
—
MI
01
—
9741241
AETNA
MI
01
—
P00473887
RAILROAD MEDICARE
MI
Enumeration date
10/16/2006
Last updated
02/07/2014
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