Healthcare Provider Details

I. General information

NPI: 1144504168
Provider Name (Legal Business Name): KALA KLUENDER RN, MSN, CNM
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/10/2011
Last Update Date: 10/10/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4800 RIVERBEND RD SUITE 150
BOULDER CO
80301-2636
US

IV. Provider business mailing address

1934 18TH ST #23
BOULDER CO
80302-5548
US

V. Phone/Fax

Practice location:
  • Phone: 303-443-2229
  • Fax: 720-317-2312
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN-198428
License Number StateCO
# 2
Primary TaxonomyY
Taxonomy Code176B00000X
TaxonomyMidwife
License NumberCNM-170018
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: