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NPI Code Detail

MEDICARE: MRS. KRISTINE MARKLEY BRISTOW FNP, MSN, RN, CS

MEDICARE: MRS. KRISTINE MARKLEY BRISTOW FNP, MSN, RN, CS
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363LF0000XFamily Nurse Practitioner658AK
2363LF0000XFamily Nurse Practitioner120453CO

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1437118569
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. KRISTINE MARKLEY BRISTOW FNP, MSN, RN, CS
Provider Business Mailing Address
First Line : 4301 RIDGECREST DR
Second Line :
City : COLORADO SPRINGS
State : CO
Zip : 80918-4323
Country : US
Telephone Number : 719-268-7199
Fax Number :
Provider Business Practice Location Address
First Line : 8890 N UNION BLVD STE 200
Second Line :
City : COLORADO SPRINGS
State : CO
Zip : 80920-2701
Country : US
Telephone Number : 719-365-6419
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/18/2006
Last Update Date : 07/08/2010

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