Healthcare Provider Details

I. General information

NPI: 1700176708
Provider Name (Legal Business Name): KAYLIN A KLIE M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/11/2011
Last Update Date: 10/09/2022
Certification Date: 10/09/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1693 QUENTIN ST
AURORA CO
80045-2518
US

IV. Provider business mailing address

1693 QUENTIN ST
AURORA CO
80045-2518
US

V. Phone/Fax

Practice location:
  • Phone: 720-848-3000
  • Fax: 720-848-3015
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number54306
License Number StateCO
# 2
Primary TaxonomyN
Taxonomy Code2084A0401X
TaxonomyAddiction Medicine (Psychiatry & Neurology) Physician
License Number54306
License Number StateCO
# 3
Primary TaxonomyY
Taxonomy Code207QA0401X
TaxonomyAddiction Medicine (Family Medicine) Physician
License Number54306
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: