Healthcare Provider Details

I. General information

NPI: 1093976532
Provider Name (Legal Business Name): CHRISTINA KUTZ
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/18/2008
Last Update Date: 06/18/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1055 CLERMONT ST PHARMACY DEPT
DENVER CO
80220-3808
US

IV. Provider business mailing address

1055 CLERMONT ST PHARMACY DEPT
DENVER CO
80220-3808
US

V. Phone/Fax

Practice location:
  • Phone: 303-399-8020
  • Fax:
Mailing address:
  • Phone: 303-399-8020
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number16384
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: