Provider Demographics
NPI:1811158918
Name:KRUTKA, APRIL L (DO)
Entity type:Individual
Prefix:
First Name:APRIL
Middle Name:L
Last Name:KRUTKA
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:APRIL
Other - Middle Name:L
Other - Last Name:PARKS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DO
Mailing Address - Street 1:2754 COMPASS DR
Mailing Address - Street 2:
Mailing Address - City:GRAND JUNCTION
Mailing Address - State:CO
Mailing Address - Zip Code:81506-8714
Mailing Address - Country:US
Mailing Address - Phone:970-241-2212
Mailing Address - Fax:
Practice Address - Street 1:2754 COMPASS DR
Practice Address - Street 2:
Practice Address - City:GRAND JUNCTION
Practice Address - State:CO
Practice Address - Zip Code:81506-8714
Practice Address - Country:US
Practice Address - Phone:970-241-2212
Practice Address - Fax:970-257-2401
Is Sole Proprietor?:No
Enumeration Date:2008-06-20
Last Update Date:2024-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO0003418207QH0002X, 207Q00000X
CO148909207QH0002X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207QH0002XAllopathic & Osteopathic PhysiciansFamily MedicineHospice and Palliative Medicine
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO68450079Medicaid