1225090996 NPI number — MRS. KJERSTEN E. OSTROM-CONDOJANI M.A.,CAC III

Table of content: MRS. KJERSTEN E. OSTROM-CONDOJANI M.A.,CAC III (NPI 1225090996)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1225090996 NPI number — MRS. KJERSTEN E. OSTROM-CONDOJANI M.A.,CAC III

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
OSTROM-CONDOJANI
Provider First Name:
KJERSTEN
Provider Middle Name:
E.
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
M.A.,CAC III
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
CONDOJANI
Provider Other First Name:
KJERSTEN
Provider Other Middle Name:
E.
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
M.A., CAC III
Provider Other Last Name Type Code:
5

NPI Number Information

NPI Number:
1225090996
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/08/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
8000 S LINCOLN ST
Provider Second Line Business Mailing Address:
SUITE #210
Provider Business Mailing Address City Name:
LITTLETON
Provider Business Mailing Address State Name:
CO
Provider Business Mailing Address Postal Code:
80122-2714
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
303-730-1212
Provider Business Mailing Address Fax Number:
303-730-3740

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
8000 S LINCOLN ST
Provider Second Line Business Practice Location Address:
SUITE #210
Provider Business Practice Location Address City Name:
LITTLETON
Provider Business Practice Location Address State Name:
CO
Provider Business Practice Location Address Postal Code:
80122-2714
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
303-730-1212
Provider Business Practice Location Address Fax Number:
303-730-3740
Provider Enumeration Date:
04/06/2006

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: 101YA0400X , with the licence number:  5769 , 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)





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