1528322286 NPI number — DR. KRISTIN A KLINGENSTEIN D.P.M.

Table of content: DR. KRISTIN A KLINGENSTEIN D.P.M. (NPI 1528322286)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1528322286 NPI number — DR. KRISTIN A KLINGENSTEIN D.P.M.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
KLINGENSTEIN
Provider First Name:
KRISTIN
Provider Middle Name:
A
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
D.P.M.
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1528322286
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
10/05/2015
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
4506 CAMILA CT
Provider Second Line Business Mailing Address:
UNIT C
Provider Business Mailing Address City Name:
ANCHORAGE
Provider Business Mailing Address State Name:
AK
Provider Business Mailing Address Postal Code:
99508-2781
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
907-562-4958
Provider Business Mailing Address Fax Number:
907-562-5195

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1055 CLERMONT ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
DENVER
Provider Business Practice Location Address State Name:
CO
Provider Business Practice Location Address Postal Code:
80220-3808
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
303-399-8020
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
06/27/2012

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 213ES0103X , with the licence number:  PDT-527 , registered in the state of CO ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 920148358 . This is a "TAX ID" identifier , issued by the state of ( AK ) . This identifiers is of the category "OTHER".




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