Basic Information
| Provider Information | |||||||||
| NPI: | 1780907147 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | KRIEGER | ||||||||
| FirstName: | KELLY | ||||||||
| MiddleName: | PAULINE | ||||||||
| NamePrefix: | MS. | ||||||||
| NameSuffix: | |||||||||
| Credential: | N.P | ||||||||
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| Mailing Information | |||||||||
| Address1: | 6750 W 52ND AVE | ||||||||
| Address2: | |||||||||
| City: | ARVADA | ||||||||
| State: | CO | ||||||||
| PostalCode: | 800029359 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3033290870 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 6750 W 52ND AVE | ||||||||
| Address2: | |||||||||
| City: | ARVADA | ||||||||
| State: | CO | ||||||||
| PostalCode: | 800028000 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3033290870 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/12/2010 | ||||||||
| LastUpdateDate: | 02/17/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 02/17/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LF0000X | NP-10086 | CO | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Family |
No ID Information.