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General NPI Number Information
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NPI Number | 1891004594
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Entity Type | Individual
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Provider Name | CHRISTINE A. CARROLL
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Gender | Female
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Dates
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Enumeration Date | 09/28/2010
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Last Update Date | 06/12/2015
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Provider Practice Location Address
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Address Line | 10101 RIDGEGATE PKWY
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City | LONE TREE
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State | CO
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Zip | 80124-5522
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Country | US
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Telephone | 719-225-1900
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 173862
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City | DENVER
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State | CO
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Zip | 80217-3862
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Country | US
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Telephone | 303-306-7783
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Fax | 303-306-7753
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 3085
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License Number State | CO
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