Provider Demographics
NPI:1760036107
Name:STANGE, KRISTINA (PA-C)
Entity Type:Individual
Prefix:MRS
First Name:KRISTINA
Middle Name:
Last Name:STANGE
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:206 W COUNTY LINE RD STE 340
Mailing Address - Street 2:
Mailing Address - City:HIGHLANDS RANCH
Mailing Address - State:CO
Mailing Address - Zip Code:80129-2321
Mailing Address - Country:US
Mailing Address - Phone:303-888-6426
Mailing Address - Fax:303-302-1659
Practice Address - Street 1:206 W COUNTY LINE RD STE 340
Practice Address - Street 2:
Practice Address - City:HIGHLANDS RANCH
Practice Address - State:CO
Practice Address - Zip Code:80129-2321
Practice Address - Country:US
Practice Address - Phone:303-888-6426
Practice Address - Fax:303-302-1659
Is Sole Proprietor?:No
Enumeration Date:2019-07-24
Last Update Date:2019-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COPA.0005865363A00000X, 207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No207N00000XAllopathic & Osteopathic PhysiciansDermatology