Provider Demographics
NPI:1427200914
Name:HARDT, KRISTE (PA-C)
Entity Type:Individual
Prefix:
First Name:KRISTE
Middle Name:
Last Name:HARDT
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:KRISTE
Other - Middle Name:
Other - Last Name:MARSHALL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA-C
Mailing Address - Street 1:1601 E 19TH AVE
Mailing Address - Street 2:SUITE 6300
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80218-1216
Mailing Address - Country:US
Mailing Address - Phone:303-869-2182
Mailing Address - Fax:303-869-1906
Practice Address - Street 1:9197 GRANT ST
Practice Address - Street 2:SUITE 200
Practice Address - City:THORNTON
Practice Address - State:CO
Practice Address - Zip Code:80229-4361
Practice Address - Country:US
Practice Address - Phone:303-450-3690
Practice Address - Fax:303-450-3699
Is Sole Proprietor?:No
Enumeration Date:2008-10-16
Last Update Date:2009-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO2614363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO1082594OtherNCCPA