Provider Demographics
NPI:1902677065
Name:COUSINS, KRISHNA RAYE
Entity Type:Individual
Prefix:
First Name:KRISHNA
Middle Name:RAYE
Last Name:COUSINS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1920 S UNIVERSITY BLVD APT 607D
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80210-4297
Mailing Address - Country:US
Mailing Address - Phone:202-549-8725
Mailing Address - Fax:
Practice Address - Street 1:1920 S UNIVERSITY BLVD APT 607D
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80210-4297
Practice Address - Country:US
Practice Address - Phone:202-549-8725
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-01-09
Last Update Date:2024-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program