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KRISTIN DYKSTRA PA-C
NPI 1417122011
Physician Assistant in Grand Rapids, MI

Active since April 24, 2008
4069 LAKE DR SE, SUITE 312, GRAND RAPIDS, MI 49546(616) 267-8700(616) 267-8247 Get Directions Write a Review

NPPES record last updated: October 1, 2021. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Oct 1, 2021, Mar 5, 2021 (2 updates tracked since 2021).

About Kristin Dykstra Pa-c NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

KRISTIN DYKSTRA PA-C (NPI 1417122011) is an individual physician assistant in Grand Rapids, Michigan, licensed in Michigan (5601005234) and active in the NPI registry since April 2008.

NPPES Registry Identity

NPI1417122011
Entity TypeIndividualFemale
Primary Taxonomy363A00000X
Provider Legal NameKRISTIN DYKSTRACredential: PA-C
Location Address4069 LAKE DR SE, SUITE 312Grand Rapids, MI 49546-8816
Mailing Address100 Michigan St Ne, Mc845Grand Rapids, MI 49503-2560
Phone(616) 267-8700
Fax(616) 267-8247
Sole ProprietorNo
Enumeration DateApril 24, 2008
Last NPPES UpdateOctober 1, 20212 updates tracked since enumeration
NPPES CertifiedOctober 1, 2021
✔ NPI 1417122011 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician AssistantPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363A00000X
License✔ Licensed in MI · 5601005234
Definition
A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.
4069 LAKE DR SE, Grand Rapids, MI 49546
Open in Google Maps ↗

Other Names 1

Former Name (1)Kristin Cole

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

TABETHA EMILY BERGERON PA-C
Physician Assistant
4069 LAKE DR SE
GRAND RAPIDS, MI 49546
Kent County (616) 267-7469
ROBERT CUFF MD
Surgery (Vascular Surgery)
4069 LAKE DR SE, S-312
GRAND RAPIDS, MI 49546
Kent County (616) 267-8700
SPECTRUM HEALTH PRIMARY CARE PARTNERS
Durable Medical Equipment & Medical Supplies
4069 LAKE DR SE, SUITE 315
GRAND RAPIDS, MI 49546
Kent County (616) 464-2860
SARAH L PARKER NP
Nurse Practitioner (Family)
4069 LAKE DR SE
GRAND RAPIDS, MI 49546
Kent County (616) 267-7469
SPECTRUM HEALTH PRIMARY CARE PARTNERS
Dietitian, Registered
4069 LAKE DR SE, STE. 315
GRAND RAPIDS, MI 49546
Kent County (616) 267-8950
SAVANNAH DAWN MOLNER PA
Physician Assistant
4069 LAKE DR SE
GRAND RAPIDS, MI 49546
Kent County (616) 267-7469
SPECTRUM HEALTH PRIMARY CARE PARTNERS
Family Medicine
4069 LAKE DR SE
GRAND RAPIDS, MI 49546
Kent County (616) 267-7105
AMELIA JOY ASHCRAFT PA-C
Physician Assistant
4069 LAKE DR SE
GRAND RAPIDS, MI 49546
Kent County (616) 267-7469

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Kristin Dykstra's NPI number?

The NPI number for Kristin Dykstra is 1417122011. It was assigned to this individual provider in the NPPES registry on April 24, 2008. The provider is also known as Kristin Cole.

Where is Kristin Dykstra located?

Kristin Dykstra practices at 4069 Lake Dr SE Suite 312, Grand Rapids, MI 49546. The listed phone number is (616) 267-8700.

What is Kristin Dykstra's specialty?

The primary specialty registered for this NPI is Physician Assistant with taxonomy code 363A00000X.

When was this NPI record last updated?

The NPPES record for Kristin Dykstra was last updated on October 1, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.