Individual provider Active NPI

Krysta Lee Gatliff, RN

  • Registered Nurse
  • Pueblo, CO
National Provider Identifier
1124467212
Registry record updated Jun 21, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
RN,0205485 Issued in CO
Practice address
1026 W Abriendo Ave
Pueblo, CO 81004-1128
Phone
(719) 545-2746
Fax
(719) 545-4100
NPI assigned
Jun 21, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 21, 2013

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X RN,0205485 CO Primary

Addresses

Primary practice location

1026 W Abriendo Ave
Pueblo, CO 81004-1128

Mailing address

1012 W Abriendo Ave
Pueblo, CO 81004-1128
Phone (719) 545-2746

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
RN,0205485COMDRegistered Nurse

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1371772800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1371772800000",
    "number": "1124467212",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1012 W ABRIENDO AVE",
            "city": "PUEBLO",
            "state": "CO",
            "postal_code": "810041128",
            "telephone_number": "719-545-2746",
            "fax_number": "719-545-4100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1026 W ABRIENDO AVE",
            "city": "PUEBLO",
            "state": "CO",
            "postal_code": "810041128",
            "telephone_number": "719-545-2746",
            "fax_number": "719-545-4100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GATLIFF",
        "first_name": "KRYSTA",
        "middle_name": "LEE",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-06-21",
        "last_updated": "2013-06-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CO",
            "license": "RN,0205485",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pueblo, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 21, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.