Provider Demographics
NPI:1629513767
Name:PLATE, KRISTA LEE (FNP)
Entity Type:Individual
Prefix:
First Name:KRISTA
Middle Name:LEE
Last Name:PLATE
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 1:222 JOHNSTOWN CENTER DR
Mailing Address - Street 2:
Mailing Address - City:JOHNSTOWN
Mailing Address - State:CO
Mailing Address - Zip Code:80534-9030
Mailing Address - Country:US
Mailing Address - Phone:970-587-4974
Mailing Address - Fax:
Practice Address - Street 1:222 JOHNSTOWN CENTER DR
Practice Address - Street 2:
Practice Address - City:JOHNSTOWN
Practice Address - State:CO
Practice Address - Zip Code:80534-9030
Practice Address - Country:US
Practice Address - Phone:970-587-4974
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-12-28
Last Update Date:2018-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COAPN.0992850-NP363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily