Basic Information
Provider Information
NPI: 1942509237
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: KREBS
FirstName: NICHOLAS
MiddleName: JAMES
NamePrefix: DR.
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 7501 VILLAGE SQUARE DR STE 207
Address2:  
City: CASTLE PINES
State: CO
PostalCode: 801083708
CountryCode: US
TelephoneNumber: 7207791991
FaxNumber:  
Practice Location
Address1: 7501 VILLAGE SQUARE DR STE 207
Address2:  
City: CASTLE PINES
State: CO
PostalCode: 801083708
CountryCode: US
TelephoneNumber: 7207791991
FaxNumber: 3036942680
Other Information
ProviderEnumerationDate: 03/25/2011
LastUpdateDate: 05/17/2022
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 05/17/2022

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
208000000X54126COY Allopathic & Osteopathic PhysiciansPediatrics 

No ID Information.


Home