Provider Demographics
NPI:1962498949
Name:YOUNG, KRISTI LOUISE (RN-NP)
Entity Type:Individual
Prefix:
First Name:KRISTI
Middle Name:LOUISE
Last Name:YOUNG
Suffix:
Gender:F
Credentials:RN-NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10325 COUNTY ROAD 163
Mailing Address - Street 2:
Mailing Address - City:SALIDA
Mailing Address - State:CO
Mailing Address - Zip Code:81201-8539
Mailing Address - Country:US
Mailing Address - Phone:719-530-2000
Mailing Address - Fax:719-530-2055
Practice Address - Street 1:550 W HWY 50
Practice Address - Street 2:
Practice Address - City:SALIDA
Practice Address - State:CO
Practice Address - Zip Code:81201-2238
Practice Address - Country:US
Practice Address - Phone:719-530-2000
Practice Address - Fax:719-530-2055
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-09-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO50819163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO50819OtherACTIVE REGISTERED NURSE