Provider Demographics
NPI:1720394570
Name:AVERY, KRISTIANA L (NP)
Entity Type:Individual
Prefix:
First Name:KRISTIANA
Middle Name:L
Last Name:AVERY
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:KRISTIANA
Other - Middle Name:L
Other - Last Name:HAWKINS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:4353 E COLFAX AVE
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80220-1115
Mailing Address - Country:US
Mailing Address - Phone:303-504-1200
Mailing Address - Fax:303-320-4830
Practice Address - Street 1:4353 E COLFAX AVE
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80220-1115
Practice Address - Country:US
Practice Address - Phone:303-504-1200
Practice Address - Fax:303-320-4830
Is Sole Proprietor?:No
Enumeration Date:2010-08-30
Last Update Date:2011-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CONP990096363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health