Provider Demographics
NPI:1508306143
Name:STARNES, KRYSTAL L (NP)
Entity Type:Individual
Prefix:
First Name:KRYSTAL
Middle Name:L
Last Name:STARNES
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4075 E 128TH AVE
Mailing Address - Street 2:
Mailing Address - City:THORNTON
Mailing Address - State:CO
Mailing Address - Zip Code:80241-2201
Mailing Address - Country:US
Mailing Address - Phone:303-925-4210
Mailing Address - Fax:303-925-4212
Practice Address - Street 1:4075 E 128TH AVE
Practice Address - Street 2:
Practice Address - City:THORNTON
Practice Address - State:CO
Practice Address - Zip Code:80241-2201
Practice Address - Country:US
Practice Address - Phone:303-925-4210
Practice Address - Fax:303-925-4212
Is Sole Proprietor?:No
Enumeration Date:2017-03-01
Last Update Date:2017-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COAPN.0993012-NP363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily