Provider Demographics
NPI:1689824260
Name:SCHWAB, KRISTA (BSN)
Entity Type:Individual
Prefix:
First Name:KRISTA
Middle Name:
Last Name:SCHWAB
Suffix:
Gender:F
Credentials:BSN
Other - Prefix:
Other - First Name:KRISTA
Other - Middle Name:
Other - Last Name:STAINBROOK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 6861
Mailing Address - Street 2:
Mailing Address - City:BROOMFIELD
Mailing Address - State:CO
Mailing Address - Zip Code:80021-0015
Mailing Address - Country:US
Mailing Address - Phone:720-212-4000
Mailing Address - Fax:
Practice Address - Street 1:2500 S HAVANA ST
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80014-1618
Practice Address - Country:US
Practice Address - Phone:720-212-4000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-09-19
Last Update Date:2012-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO203516163WG0000X
CO40605164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WG0000XNursing Service ProvidersRegistered NurseGeneral Practice
No164W00000XNursing Service ProvidersLicensed Practical Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO1689824260OtherNPI