Provider Demographics
NPI:1457383515
Name:ALIX, KRISTEN E (NP)
Entity Type:Individual
Prefix:MRS
First Name:KRISTEN
Middle Name:E
Last Name:ALIX
Suffix:
Gender:F
Credentials:NP
Other - Prefix:MS
Other - First Name:KRISTEN
Other - Middle Name:E
Other - Last Name:GAST
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:NP
Mailing Address - Street 1:PO BOX 110429
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80042-0429
Mailing Address - Country:US
Mailing Address - Phone:303-493-7000
Mailing Address - Fax:
Practice Address - Street 1:1444 S POTOMAC ST STE 20
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80012-4508
Practice Address - Country:US
Practice Address - Phone:303-226-4650
Practice Address - Fax:303-751-6069
Is Sole Proprietor?:No
Enumeration Date:2006-07-07
Last Update Date:2022-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO101263363L00000X
COAPN.0004263-NP363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner