Individual Healthcare Provider
Kristy Jordan Lichtenberg, PA
Provider's NPPES record last updated: December 14, 2023
Overview
- Entity Type
- Individual Healthcare Provider
- NPI
- 1134637986
- Primary Specialty
- Physician Assistant
- Practice Location
- St Paul, Minnesota
- Sole Proprietor
- No
Federal Screening
NPISignal checked this NPI against federal exclusion sources. Results below are based on the NPI number itself — an identifier match, not a name match.
List of Excluded Individuals/Entities (LEIE)
HHS Office of Inspector General
No potential match was identified in NPISignal's indexed List of Excluded Individuals/Entities (LEIE) records as of 2026-09-10.
- Source data
- September 10, 2026
- Records indexed
- 84,001
- Screened
- Sep 19, 2026, 3:23 AM UTC
This reflects only the records NPISignal currently holds and the identity information supplied. It is not a verification of eligibility, licensure, or compliance. Verify decisions that matter against the authoritative source.
SAM.gov Exclusions
U.S. General Services Administration
SAM.gov Exclusions was not checked.
SAM.gov screening is not configured on this deployment. No SAM check has been performed.
- Screened
- Not checked
This is an NPI-based check only. NPISignal does not publish name-based exclusion matches on a provider profile. A shared or similar name is a lead that requires human review, not an identification, and this page is not the place to make one. Run a name-based screening below to see potential matches with the reasons for each.
This reflects only the records NPISignal currently holds and the identity information supplied. It is not a verification of eligibility, licensure, or compliance. Verify decisions that matter against the authoritative source.
Searches OIG LEIE and SAM.gov by name and reviews every potential match.
Specialties & Taxonomies
- Primary
Physician Assistant
Physician Assistants & Advanced Practice Nursing Providers
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.
Taxonomy code 363A00000X Physician Assistant
Medical
Physician Assistants & Advanced Practice Nursing Providers
Definition to come...
Taxonomy code 363AM0700X
Provider-Reported License Information
- Physician Assistant (Minnesota)
- 12632
Practice Locations
Practice Location
225 Smith Ave N
Ste 200
St Paul, Minnesota 55102-2697
Phone: (651) 241-5111
Additional Practice Location
6565 France Ave S Ste 375
Edina, Minnesota 55435-2141
Phone: (651) 312-1700
Additional Practice Location
1415 Lilac Dr N Ste 190
Golden Valley, Minnesota 55422-4544
Phone: (763) 267-8701
Fax: (763) 231-9602
Record Information
- Enumeration Date
- January 15, 2018
- Provider's NPPES Record Last Updated
- December 14, 2023
- Certification Date
- December 14, 2023
- NPISignal NPPES Dataset
- August 2026
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