Provider Demographics
NPI:1679726640
Name:BLEW, KRISTA AW (PA-C)
Entity type:Individual
Prefix:MRS
First Name:KRISTA
Middle Name:AW
Last Name:BLEW
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:191 E ORCHARD RD
Mailing Address - Street 2:SUITE 102 NE
Mailing Address - City:LITTLETON
Mailing Address - State:CO
Mailing Address - Zip Code:80121-8000
Mailing Address - Country:US
Mailing Address - Phone:303-730-1313
Mailing Address - Fax:303-730-2090
Practice Address - Street 1:191 E ORCHARD RD
Practice Address - Street 2:SUITE 102 NE
Practice Address - City:LITTLETON
Practice Address - State:CO
Practice Address - Zip Code:80121-8000
Practice Address - Country:US
Practice Address - Phone:303-730-1313
Practice Address - Fax:303-730-2090
Is Sole Proprietor?:No
Enumeration Date:2008-11-03
Last Update Date:2008-11-03
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CO2542363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical