Healthcare Provider Details

I. General information

NPI: 1033891031
Provider Name (Legal Business Name): KRIS JOY SUTTON NBC-HWC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/01/2023
Last Update Date: 08/01/2023
Certification Date: 08/01/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7173 S HAVANA ST STE 600-201
CENTENNIAL CO
80112-3891
US

IV. Provider business mailing address

7173 S HAVANA ST STE 600-201
CENTENNIAL CO
80112-3891
US

V. Phone/Fax

Practice location:
  • Phone: 303-900-8410
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171400000X
TaxonomyHealth & Wellness Coach
License NumberA-3626554
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: