Basic Information
| Provider Information | |||||||||
| NPI: | 1235475245 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | ZINIS | ||||||||
| FirstName: | KRISTIN | ||||||||
| MiddleName: | L | ||||||||
| NamePrefix: | |||||||||
| NameSuffix: | |||||||||
| Credential: | PA | ||||||||
| OtherOrganizationName: | |||||||||
| OtherOrganizationType: | |||||||||
| OtherLastName: | HALLIWELL | ||||||||
| OtherFirstName: | KRISTIN | ||||||||
| OtherMiddleName: | |||||||||
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| OtherLastNameType: | 1 | ||||||||
| Mailing Information | |||||||||
| Address1: | 1606 PRAIRIE CENTER PKWY | ||||||||
| Address2: | STE 170 | ||||||||
| City: | BRIGHTON | ||||||||
| State: | CO | ||||||||
| PostalCode: | 806014004 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3034981885 | ||||||||
| FaxNumber: | 3034981884 | ||||||||
| Practice Location | |||||||||
| Address1: | 1606 PRAIRIE CENTER PKWY | ||||||||
| Address2: | STE 170 | ||||||||
| City: | BRIGHTON | ||||||||
| State: | CO | ||||||||
| PostalCode: | 806014004 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3034981885 | ||||||||
| FaxNumber: | 3034981884 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 12/19/2012 | ||||||||
| LastUpdateDate: | 12/19/2012 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| AuthorizedOfficialMiddleName: | |||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | |||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363A00000X | 966 | CO | Y | Physician Assistants & Advanced Practice Nursing Providers | Physician Assistant |
No ID Information.