Provider Demographics
NPI:1225024078
Name:KRASKE, CHAD A (NP)
Entity Type:Individual
Prefix:
First Name:CHAD
Middle Name:A
Last Name:KRASKE
Suffix:
Gender:M
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:4900 S MONACO ST
Mailing Address - Street 2:SUITE 210
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80237-3486
Mailing Address - Country:US
Mailing Address - Phone:303-750-0822
Mailing Address - Fax:303-750-1298
Practice Address - Street 1:1444 S POTOMAC ST
Practice Address - Street 2:SUITE 300
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80012-4508
Practice Address - Country:US
Practice Address - Phone:303-750-0822
Practice Address - Fax:303-750-1298
Is Sole Proprietor?:No
Enumeration Date:2005-09-26
Last Update Date:2022-02-01
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CO106346363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE10026280700Medicaid
CO10532218Medicaid
NE1982948089Medicaid
NE10026280600Medicaid
NE10026281000Medicaid
NE10026283100Medicaid
KS201038580AMedicaid
NE10026280800Medicaid
NE10026281200Medicaid
NE10026281000Medicaid
CO271106YN6LMedicare PIN
COQ03481Medicare UPIN
NE1982948089Medicaid
NE10026280600Medicaid
KSKA2848002Medicare PIN