Provider Demographics
NPI:1215692413
Name:RONCALES, KRYSTEL JOY (FNP)
Entity type:Individual
Prefix:
First Name:KRYSTEL JOY
Middle Name:
Last Name:RONCALES
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2355 HEATHERCREST DR APT SUITE
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80915-1462
Mailing Address - Country:US
Mailing Address - Phone:719-510-7058
Mailing Address - Fax:
Practice Address - Street 1:1914 LELARAY ST
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80909-2800
Practice Address - Country:US
Practice Address - Phone:719-955-2651
Practice Address - Fax:719-632-2925
Is Sole Proprietor?:No
Enumeration Date:2021-11-02
Last Update Date:2021-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COAPN.0996869-NP363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily