Provider Demographics
NPI:1073339990
Name:KAUMP, KRYSTA (DACM, LAC)
Entity type:Individual
Prefix:
First Name:KRYSTA
Middle Name:
Last Name:KAUMP
Suffix:
Gender:F
Credentials:DACM, LAC
Other - Prefix:
Other - First Name:KRYSTA
Other - Middle Name:
Other - Last Name:KAUMP
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DACM, LAC
Mailing Address - Street 1:10013 ARMADILLO DR
Mailing Address - Street 2:
Mailing Address - City:LONE TREE
Mailing Address - State:CO
Mailing Address - Zip Code:80124-9720
Mailing Address - Country:US
Mailing Address - Phone:303-941-4483
Mailing Address - Fax:
Practice Address - Street 1:3989 E ARAPAHOE RD STE 120
Practice Address - Street 2:
Practice Address - City:CENTENNIAL
Practice Address - State:CO
Practice Address - Zip Code:80122-2077
Practice Address - Country:US
Practice Address - Phone:303-740-2026
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-11-25
Last Update Date:2024-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COACU.0002883171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist