Provider Demographics
NPI:1184326985
Name:BENSON, KRISTINE (APN, RN)
Entity type:Individual
Prefix:
First Name:KRISTINE
Middle Name:
Last Name:BENSON
Suffix:
Gender:F
Credentials:APN, RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6405 W 46TH PL
Mailing Address - Street 2:
Mailing Address - City:WHEAT RIDGE
Mailing Address - State:CO
Mailing Address - Zip Code:80033-3750
Mailing Address - Country:US
Mailing Address - Phone:205-877-3017
Mailing Address - Fax:
Practice Address - Street 1:10900 W 44TH AVE UNIT 200
Practice Address - Street 2:
Practice Address - City:WHEAT RIDGE
Practice Address - State:CO
Practice Address - Zip Code:80033-2742
Practice Address - Country:US
Practice Address - Phone:303-993-1330
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-03-17
Last Update Date:2023-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO0998561363LG0600X
CO1622581163WG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology
No163WG0600XNursing Service ProvidersRegistered NurseGerontology