MEDICARE: KIRSTEN SHAYE BOATRIGHT

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	106S00000X	Behavior Technician	RBT-25-422974	CO

General Provider Information

NPI Number	:	1760334825
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KIRSTEN SHAYE BOATRIGHT

Provider Business Mailing Address
First Line	:	1621 WIDEFIELD DR
Second Line	:
City	:	COLORADO SPRINGS
State	:	CO
Zip	:	80911-1107
Country	:	US
Telephone Number	:	910-336-5511
Fax Number	:

Provider Business Practice Location Address
First Line	:	1621 WIDEFIELD DR
Second Line	:
City	:	COLORADO SPRINGS
State	:	CO
Zip	:	80911-1107
Country	:	US
Telephone Number	:	910-336-5511
Fax Number	:

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

Provider Enumeration Date	:	02/11/2026
Last Update Date	:	02/11/2026

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Directions to “ KIRSTEN SHAYE BOATRIGHT ” Practice Location

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