Provider Demographics
NPI:1235133901
Name:BARNES, KRISTINE K (RN)
Entity Type:Individual
Prefix:
First Name:KRISTINE
Middle Name:K
Last Name:BARNES
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3450 BROADWAY ST
Mailing Address - Street 2:
Mailing Address - City:BOULDER
Mailing Address - State:CO
Mailing Address - Zip Code:80304-1824
Mailing Address - Country:US
Mailing Address - Phone:303-441-1175
Mailing Address - Fax:303-441-1452
Practice Address - Street 1:3482 BROADWAY ST
Practice Address - Street 2:
Practice Address - City:BOULDER
Practice Address - State:CO
Practice Address - Zip Code:80304-1824
Practice Address - Country:US
Practice Address - Phone:303-413-7500
Practice Address - Fax:303-441-1452
Is Sole Proprietor?:No
Enumeration Date:2005-06-09
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO169089163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO84258811Medicaid