MEDICARE: KRISTIN ALLDREDGE

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	163W00000X	Registered Nurse	RN.0189328	CO

General Provider Information

NPI Number	:	1164392411
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KRISTIN ALLDREDGE

Provider Business Mailing Address
First Line	:	755 HIGHWAY 105 STE D
Second Line	:
City	:	PALMER LAKE
State	:	CO
Zip	:	80133-8902
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	755 HIGHWAY 105 STE D
Second Line	:
City	:	PALMER LAKE
State	:	CO
Zip	:	80133-8902
Country	:	US
Telephone Number	:	303-330-5255
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/10/2025
Last Update Date	:	11/10/2025

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Directions to “ KRISTIN ALLDREDGE ” Practice Location

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