Provider Demographics
NPI:1619969425
Name:KREIN, JANET LOUISE (PA-C)
Entity Type:Individual
Prefix:MRS
First Name:JANET
Middle Name:LOUISE
Last Name:KREIN
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:MRS
Other - First Name:JANET
Other - Middle Name:NORRIS
Other - Last Name:KREIN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PA-C
Mailing Address - Street 1:614 YALE PL
Mailing Address - Street 2:
Mailing Address - City:CANON CITY
Mailing Address - State:CO
Mailing Address - Zip Code:81212-4611
Mailing Address - Country:US
Mailing Address - Phone:719-285-2700
Mailing Address - Fax:719-285-2975
Practice Address - Street 1:614 YALE PL
Practice Address - Street 2:
Practice Address - City:CANON CITY
Practice Address - State:CO
Practice Address - Zip Code:81212-4611
Practice Address - Country:US
Practice Address - Phone:719-285-2700
Practice Address - Fax:719-285-2975
Is Sole Proprietor?:No
Enumeration Date:2005-08-17
Last Update Date:2014-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ2950363A00000X
CO2675363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
1022061OtherNCCPA