Provider Demographics
NPI:1285879130
Name:DANGREMOND, KRISTINE RASMUSSEN (MD)
Entity type:Individual
Prefix:DR
First Name:KRISTINE
Middle Name:RASMUSSEN
Last Name:DANGREMOND
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:KRISTINE
Other - Middle Name:MARIE
Other - Last Name:RASMUSSEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:1330 QUAIL LAKE LOOP STE 240
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80906-4651
Mailing Address - Country:US
Mailing Address - Phone:719-900-3633
Mailing Address - Fax:719-900-5148
Practice Address - Street 1:1330 QUAIL LAKE LOOP STE 240
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80906-4651
Practice Address - Country:US
Practice Address - Phone:719-900-3633
Practice Address - Fax:719-900-5148
Is Sole Proprietor?:Yes
Enumeration Date:2008-12-06
Last Update Date:2022-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMMD201308382084P0804X
CO00535942084P0804X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry