Basic Information
| Provider Information | |||||||||
| NPI: | 1194784355 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | FRANDSEN | ||||||||
| FirstName: | KRISTIN | ||||||||
| MiddleName: | MARLENA | ||||||||
| NamePrefix: | MRS. | ||||||||
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| Credential: | P.T. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 22346 EAGLE RUN LN | ||||||||
| Address2: | |||||||||
| City: | PARKER | ||||||||
| State: | CO | ||||||||
| PostalCode: | 801383122 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2622710496 | ||||||||
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| Practice Location | |||||||||
| Address1: | 4348 WOODLANDS BLVD STE 100 | ||||||||
| Address2: | |||||||||
| City: | CASTLE ROCK | ||||||||
| State: | CO | ||||||||
| PostalCode: | 801042815 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3036605349 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 03/17/2006 | ||||||||
| LastUpdateDate: | 10/24/2016 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225100000X | 10382-024 | WI | N | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist | 225100000X | PTL.0013089 | CO | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist |
ID Information
| ID | Type | State | Issuer | Description | 41810600 | 05 | WI | MEDICAID |