Healthcare Provider Details

I. General information

NPI: 1134042740
Provider Name (Legal Business Name): KRISTIN MARIE KOEHLER MS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: KRISTIN MARIE PORTER MS

II. Dates (important events)

Enumeration Date: 07/31/2026
Last Update Date: 07/31/2026
Certification Date: 07/31/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5750 CLEAR CREEK DR
DENVER CO
80212-2836
US

IV. Provider business mailing address

5750 CLEAR CREEK DR
DENVER CO
80212-2836
US

V. Phone/Fax

Practice location:
  • Phone: 720-940-1944
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171400000X
TaxonomyHealth & Wellness Coach
License Number
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: