Provider Demographics
NPI:1487713541
Name:GALATAS, KRISTALAINE (PA)
Entity type:Individual
Prefix:
First Name:KRISTALAINE
Middle Name:
Last Name:GALATAS
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 60
Mailing Address - Street 2:
Mailing Address - City:ENGLEWOOD
Mailing Address - State:CO
Mailing Address - Zip Code:80151-0060
Mailing Address - Country:US
Mailing Address - Phone:303-493-5200
Mailing Address - Fax:720-570-2012
Practice Address - Street 1:799 E HAMPDEN AVE STE 300
Practice Address - Street 2:
Practice Address - City:ENGLEWOOD
Practice Address - State:CO
Practice Address - Zip Code:80113-2762
Practice Address - Country:US
Practice Address - Phone:303-788-6490
Practice Address - Fax:303-788-5451
Is Sole Proprietor?:No
Enumeration Date:2006-12-06
Last Update Date:2019-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO2306363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO36403865Medicaid
CO020835OtherKAISER COMMERCIAL NUMBER
CO020835OtherKAISER COMMERCIAL NUMBER
NEP11984Medicare UPIN