Provider Demographics
NPI:1568148591
Name:KARGE, KRISTEN RENE
Entity Type:Individual
Prefix:
First Name:KRISTEN
Middle Name:RENE
Last Name:KARGE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10351 E SONOMA TRL
Mailing Address - Street 2:
Mailing Address - City:PARKER
Mailing Address - State:CO
Mailing Address - Zip Code:80138-6716
Mailing Address - Country:US
Mailing Address - Phone:303-525-5418
Mailing Address - Fax:
Practice Address - Street 1:10351 E SONOMA TRL
Practice Address - Street 2:
Practice Address - City:PARKER
Practice Address - State:CO
Practice Address - Zip Code:80138-6716
Practice Address - Country:US
Practice Address - Phone:303-525-5418
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-06-26
Last Update Date:2023-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO639OtherSP 639 COMMUNITY CONNECTOR