Healthcare Provider Details

I. General information

NPI: 1619575321
Provider Name (Legal Business Name): KRISTEN HOWORKO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/14/2020
Last Update Date: 10/14/2020
Certification Date: 10/14/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6524 E 162ND DR
BRIGHTON CO
80602-7595
US

IV. Provider business mailing address

6524 E 162ND DR
BRIGHTON CO
80602-7595
US

V. Phone/Fax

Practice location:
  • Phone: 303-416-6104
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WL0100X
TaxonomyLactation Consultant (Registered Nurse)
License NumberRN.1642416
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: