Individual
KRISTA SHAW WIESE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
111 6TH ST, HUGO, CO 80821-2002
(719) 743-2421
Mailing address
5600 S QUEBEC ST STE 312A, GREENWOOD VILLAGE, CO 80111-2208
(303) 436-2727
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
DR0065476
CO
Other
Enumeration date
04/06/2018
Last updated
06/17/2021
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