Provider Demographics
NPI:1972948974
Name:DEMMERT, KRISTIN (APN)
Entity Type:Individual
Prefix:
First Name:KRISTIN
Middle Name:
Last Name:DEMMERT
Suffix:
Gender:F
Credentials:APN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2055 N HIGH ST STE 230
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80205-5507
Mailing Address - Country:US
Mailing Address - Phone:303-860-9990
Mailing Address - Fax:
Practice Address - Street 1:2055 N HIGH ST STE 230
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80205-5507
Practice Address - Country:US
Practice Address - Phone:303-860-9990
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-05-03
Last Update Date:2024-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO0990662363LP0808X, 363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health
No363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO023656OtherKAISER COMMERCIAL NUMBER
CO08370877Medicaid
CO08370877Medicaid