Healthcare Provider Details

I. General information

NPI: 1083922579
Provider Name (Legal Business Name): KRISTIN M JONES-CHILLEMI R.N., CDE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/17/2010
Last Update Date: 09/17/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3150 N 12TH ST
GRAND JUNCTION CO
81506-2863
US

IV. Provider business mailing address

PO BOX 10700
GRAND JUNCTION CO
81502-5517
US

V. Phone/Fax

Practice location:
  • Phone: 970-255-1576
  • Fax:
Mailing address:
  • Phone: 970-255-1576
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WD0400X
TaxonomyDiabetes Educator Registered Nurse
License Number150024
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: