Provider Demographics
NPI:1851761191
Name:ANDERSON, KRISTIN NICOLE (PT, DPT, OCS, CLT)
Entity Type:Individual
Prefix:
First Name:KRISTIN
Middle Name:NICOLE
Last Name:ANDERSON
Suffix:
Gender:F
Credentials:PT, DPT, OCS, CLT
Other - Prefix:
Other - First Name:KRISTIN
Other - Middle Name:NICOLE
Other - Last Name:BUESING
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT, DPT
Mailing Address - Street 1:6143 S WILLOW DR STE 406
Mailing Address - Street 2:
Mailing Address - City:GREENWOOD VILLAGE
Mailing Address - State:CO
Mailing Address - Zip Code:80111-5125
Mailing Address - Country:US
Mailing Address - Phone:720-926-0103
Mailing Address - Fax:720-547-1534
Practice Address - Street 1:6143 S WILLOW DR STE 406
Practice Address - Street 2:
Practice Address - City:GREENWOOD VILLAGE
Practice Address - State:CO
Practice Address - Zip Code:80111-5125
Practice Address - Country:US
Practice Address - Phone:720-926-0103
Practice Address - Fax:720-547-1534
Is Sole Proprietor?:No
Enumeration Date:2015-09-29
Last Update Date:2023-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2015033669225100000X
KS1105234225100000X
CO0010886225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist