Healthcare Provider Details

I. General information

NPI: 1659773612
Provider Name (Legal Business Name): ERIC JONATHAN KRINSKY PA-C
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/22/2014
Last Update Date: 09/15/2026
Certification Date: 09/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4025 ST CLOUD DR STE 110
LOVELAND CO
80538-8960
US

IV. Provider business mailing address

4025 ST CLOUD DR STE 110
LOVELAND CO
80538-8960
US

V. Phone/Fax

Practice location:
  • Phone: 970-667-0304
  • Fax: 970-669-5153
Mailing address:
  • Phone: 970-667-0304
  • Fax: 970-669-5153

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number3168
License Number StateNE
# 2
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberPA.0007268
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: