Provider Demographics
NPI:1285213033
Name:GUNDT, KRISTIN (FNP)
Entity Type:Individual
Prefix:
First Name:KRISTIN
Middle Name:
Last Name:GUNDT
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2325 I RD
Mailing Address - Street 2:
Mailing Address - City:GRAND JUNCTION
Mailing Address - State:CO
Mailing Address - Zip Code:81505-9645
Mailing Address - Country:US
Mailing Address - Phone:970-201-2484
Mailing Address - Fax:
Practice Address - Street 1:2478 PATTERSON RD STE 17
Practice Address - Street 2:
Practice Address - City:GRAND JUNCTION
Practice Address - State:CO
Practice Address - Zip Code:81505-3606
Practice Address - Country:US
Practice Address - Phone:970-985-4506
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-04-07
Last Update Date:2021-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COAPN.0996241-NP363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner