Healthcare Provider Details

I. General information

NPI: 1184754921
Provider Name (Legal Business Name): CHRISTAIN L ONDRIEZEK
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/07/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2045 FRANKLIN ST
DENVER CO
80205-5437
US

IV. Provider business mailing address

620 S DAHLIA CIR APT. M304
GLENDALE CO
80246-1355
US

V. Phone/Fax

Practice location:
  • Phone: 303-743-5855
  • Fax:
Mailing address:
  • Phone: 720-427-5201
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WG0100X
TaxonomyGastroenterology Registered Nurse
License Number160604
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: