Provider Demographics
NPI:1356709026
Name:MUNKS, KRISTEN E (PA-C)
Entity type:Individual
Prefix:
First Name:KRISTEN
Middle Name:E
Last Name:MUNKS
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 1:1830 BLAKE AVE STE 202
Mailing Address - Street 2:
Mailing Address - City:GLENWOOD SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:81601-4261
Mailing Address - Country:US
Mailing Address - Phone:970-384-7510
Mailing Address - Fax:970-384-7511
Practice Address - Street 1:1830 BLAKE AVE STE 202
Practice Address - Street 2:
Practice Address - City:GLENWOOD SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:81601-4261
Practice Address - Country:US
Practice Address - Phone:970-384-7510
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-02-09
Last Update Date:2022-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORPA176310363A00000X
COPA0005176363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant