Provider Demographics
NPI:1962011320
Name:MESKE, KRISTINE MARIE (OD)
Entity type:Individual
Prefix:DR
First Name:KRISTINE
Middle Name:MARIE
Last Name:MESKE
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9529 TROON VILLAGE DR
Mailing Address - Street 2:
Mailing Address - City:LONE TREE
Mailing Address - State:CO
Mailing Address - Zip Code:80124-3148
Mailing Address - Country:US
Mailing Address - Phone:602-510-3983
Mailing Address - Fax:
Practice Address - Street 1:8089 S LINCOLN ST STE 103
Practice Address - Street 2:
Practice Address - City:LITTLETON
Practice Address - State:CO
Practice Address - Zip Code:80122-2719
Practice Address - Country:US
Practice Address - Phone:303-471-2015
Practice Address - Fax:303-271-2042
Is Sole Proprietor?:Yes
Enumeration Date:2020-07-30
Last Update Date:2024-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO00003865152W00000X
ORATI4526152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist