MEDICARE: KIM NEARY

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	163WL0100X	Lactation Consultant (Registered Nurse)	RN1694971	CO

General Provider Information

NPI Number	:	1437963337
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KIM NEARY

Provider Business Mailing Address
First Line	:	2190 BRYANT ST APT 2-106
Second Line	:
City	:	DENVER
State	:	CO
Zip	:	80211-5160
Country	:	US
Telephone Number	:	603-667-5204
Fax Number	:

Provider Business Practice Location Address
First Line	:	2190 BRYANT ST APT 2-106
Second Line	:
City	:	DENVER
State	:	CO
Zip	:	80211-5160
Country	:	US
Telephone Number	:	603-667-5204
Fax Number	:

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

Provider Enumeration Date	:	02/03/2025
Last Update Date	:	02/03/2025

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Directions to “ KIM NEARY ” Practice Location

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