Provider Demographics
NPI:1396077384
Name:VIEHMAN, KRISTEN DORAK (PA-C)
Entity type:Individual
Prefix:MRS
First Name:KRISTEN
Middle Name:DORAK
Last Name:VIEHMAN
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5351 S ROSLYN ST STE 200
Mailing Address - Street 2:
Mailing Address - City:GREENWOOD VILLAGE
Mailing Address - State:CO
Mailing Address - Zip Code:80111-2132
Mailing Address - Country:US
Mailing Address - Phone:303-469-3182
Mailing Address - Fax:303-469-4693
Practice Address - Street 1:5351 S ROSLYN ST STE 200
Practice Address - Street 2:
Practice Address - City:GREENWOOD VILLAGE
Practice Address - State:CO
Practice Address - Zip Code:80111-2132
Practice Address - Country:US
Practice Address - Phone:303-469-3182
Practice Address - Fax:303-469-4693
Is Sole Proprietor?:No
Enumeration Date:2010-02-02
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDC0004135363AS0400X
CO3406363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD204353Y1KMedicare UPIN