Provider Demographics
NPI:1174833461
Name:RILEY, KRISTYN MARIE MAGULAK (ANP)
Entity Type:Individual
Prefix:MS
First Name:KRISTYN
Middle Name:MARIE MAGULAK
Last Name:RILEY
Suffix:
Gender:F
Credentials:ANP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1770 ELM ST
Mailing Address - Street 2:
Mailing Address - City:GOLDEN
Mailing Address - State:CO
Mailing Address - Zip Code:80401-1812
Mailing Address - Country:US
Mailing Address - Phone:033-273-3381
Mailing Address - Fax:303-273-3623
Practice Address - Street 1:1770 ELM ST
Practice Address - Street 2:
Practice Address - City:GOLDEN
Practice Address - State:CO
Practice Address - Zip Code:80401-1812
Practice Address - Country:US
Practice Address - Phone:033-273-3381
Practice Address - Fax:303-273-3623
Is Sole Proprietor?:No
Enumeration Date:2010-10-20
Last Update Date:2023-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL209.007759363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health