Provider Demographics
NPI:1235475245
Name:ZINIS, KRISTIN L (PA)
Entity Type:Individual
Prefix:
First Name:KRISTIN
Middle Name:L
Last Name:ZINIS
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:KRISTIN
Other - Middle Name:
Other - Last Name:HALLIWELL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1606 PRAIRIE CENTER PKWY
Mailing Address - Street 2:STE 170
Mailing Address - City:BRIGHTON
Mailing Address - State:CO
Mailing Address - Zip Code:80601-4004
Mailing Address - Country:US
Mailing Address - Phone:303-498-1885
Mailing Address - Fax:303-498-1884
Practice Address - Street 1:1606 PRAIRIE CENTER PKWY
Practice Address - Street 2:STE 170
Practice Address - City:BRIGHTON
Practice Address - State:CO
Practice Address - Zip Code:80601-4004
Practice Address - Country:US
Practice Address - Phone:303-498-1885
Practice Address - Fax:303-498-1884
Is Sole Proprietor?:No
Enumeration Date:2012-12-19
Last Update Date:2012-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO966363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant