MEDICARE: MS. KRISTENE CHAMBERS MAYER C.F.A.

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	246ZS0410X	Surgical Technologist	00F706	CO

General Provider Information

NPI Number	:	1811098155
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. KRISTENE CHAMBERS MAYER C.F.A.

Provider Business Mailing Address
First Line	:	1821 GORDON DR
Second Line	:
City	:	ERIE
State	:	CO
Zip	:	80516-7205
Country	:	US
Telephone Number	:	303-926-8207
Fax Number	:	303-926-8207

Provider Business Practice Location Address
First Line	:	1821 GORDON DR
Second Line	:
City	:	ERIE
State	:	CO
Zip	:	80516-7205
Country	:	US
Telephone Number	:	720-352-1423
Fax Number	:	303-926-8207

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

Provider Enumeration Date	:	09/26/2006
Last Update Date	:	07/08/2007

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