Healthcare Provider Details

I. General information

NPI: 1447394655
Provider Name (Legal Business Name): KRISTEN M MCMANUS-MILLER APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/19/2007
Last Update Date: 03/28/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

411 OAK ST. ATTN CREDENTIALS
CINCINNATI OH
45219
US

IV. Provider business mailing address

EVANS ARMY COMMUNITY HOSPITAL 1650 COCHRANE CIRCLE
FORT CARSON CO
80913
US

V. Phone/Fax

Practice location:
  • Phone: 513-984-1800
  • Fax: 513-984-4909
Mailing address:
  • Phone: 719-524-0200
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberAPRN 974
License Number StateHI
# 2
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number974
License Number StateHI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: