Provider Demographics
NPI:1689007536
Name:COUPAL, KRISTIN ANNA (RN)
Entity Type:Individual
Prefix:MRS
First Name:KRISTIN
Middle Name:ANNA
Last Name:COUPAL
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:KRISTIN
Other - Middle Name:ANNA
Other - Last Name:MILLER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:7171 S CHEROKEE TRL
Mailing Address - Street 2:APT 2735
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80016-2287
Mailing Address - Country:US
Mailing Address - Phone:303-519-4096
Mailing Address - Fax:
Practice Address - Street 1:7171 S CHEROKEE TRL
Practice Address - Street 2:APT 2735
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80016-2287
Practice Address - Country:US
Practice Address - Phone:303-519-4096
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-08-14
Last Update Date:2013-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO1622079163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse