Basic Information
| Provider Information | |||||||||
| NPI: | 1912311671 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | KREGER | ||||||||
| FirstName: | JULIA | ||||||||
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| Mailing Information | |||||||||
| Address1: | 919 GRAND AVE | ||||||||
| Address2: | |||||||||
| City: | GLENWOOD SPRINGS | ||||||||
| State: | CO | ||||||||
| PostalCode: | 816013601 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9709306490 | ||||||||
| FaxNumber: | 3033182481 | ||||||||
| Practice Location | |||||||||
| Address1: | 1960 OGDEN ST | ||||||||
| Address2: | SUITE 400 | ||||||||
| City: | DENVER | ||||||||
| State: | CO | ||||||||
| PostalCode: | 802183666 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3033181540 | ||||||||
| FaxNumber: | 3033182481 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/19/2014 | ||||||||
| LastUpdateDate: | 10/11/2019 | ||||||||
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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 | 390200000X | TL.0005336 | CO | N | Student, Health Care | Student in an Organized Health Care Education/Training Program | 207N00000X | 1912311671 | CO | Y | Allopathic & Osteopathic Physicians | Dermatology |
No ID Information.