Individual
KRISTIN VAN KONYNENBURG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
600 S AIRPORT RD UNIT A203, LONGMONT, CO 80503-6427
(303) 776-0467
(303) 776-0387
Mailing address
1067 S HOVER ST, UNIT E, LONGMONT, CO 80501-7904
(720) 253-5648
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
42439
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
31238505
—
CO
Enumeration date
11/18/2005
Last updated
04/15/2021
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