MEDICARE: MS. NIKKOLE ALBERTA KYSER

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YM0800X	Mental Health Counselor
2	390200000X	Student in an Organized Health Care Education/Training Program

General Provider Information

NPI Number	:	1437281011
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. NIKKOLE ALBERTA KYSER

Provider Business Mailing Address
First Line	:	1175 S CATHAY ST
Second Line	:
City	:	AURORA
State	:	CO
Zip	:	80017-4510
Country	:	US
Telephone Number	:	720-628-1524
Fax Number	:

Provider Business Practice Location Address
First Line	:	3940 S NARCISSUS WAY
Second Line	:
City	:	DENVER
State	:	CO
Zip	:	80237-2024
Country	:	US
Telephone Number	:	303-639-9728
Fax Number	:	303-757-4478

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/10/2007
Last Update Date	:	09/11/2025

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