Provider Demographics
NPI:1750750279
Name:KRAL, TRISTA (PAC)
Entity type:Individual
Prefix:MRS
First Name:TRISTA
Middle Name:
Last Name:KRAL
Suffix:
Gender:F
Credentials:PAC
Other - Prefix:
Other - First Name:TRISTA
Other - Middle Name:
Other - Last Name:SWIFT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA
Mailing Address - Street 1:9895 W REMINGTON PL
Mailing Address - Street 2:
Mailing Address - City:LITTLETON
Mailing Address - State:CO
Mailing Address - Zip Code:80128-6734
Mailing Address - Country:US
Mailing Address - Phone:303-948-2676
Mailing Address - Fax:
Practice Address - Street 1:9895 W REMINGTON PL
Practice Address - Street 2:
Practice Address - City:LITTLETON
Practice Address - State:CO
Practice Address - Zip Code:80128-6734
Practice Address - Country:US
Practice Address - Phone:303-948-2676
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-09-15
Last Update Date:2021-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COPA0004423363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical