Healthcare Provider Details

I. General information

NPI: 1992069124
Provider Name (Legal Business Name): AMY J. KREYKES MD, MPH
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/03/2012
Last Update Date: 07/11/2022
Certification Date: 07/11/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1101 OAKRIDGE DR UNIT B
FORT COLLINS CO
80525-5536
US

IV. Provider business mailing address

301 UNIVERSITY BLVD
GALVESTON TX
77555-1110
US

V. Phone/Fax

Practice location:
  • Phone: 970-223-1199
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207QS0010X
TaxonomySports Medicine (Family Medicine) Physician
License NumberR8398
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: