Healthcare Provider Details

I. General information

NPI: 1164643516
Provider Name (Legal Business Name): ANN KURENE YOUNG R.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/02/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1780 S BELLAIRE ST STE 515
DENVER CO
80222-4326
US

IV. Provider business mailing address

14124 W DARTMOUTH AVE
LAKEWOOD CO
80228-5440
US

V. Phone/Fax

Practice location:
  • Phone: 303-759-5316
  • Fax: 303-759-5320
Mailing address:
  • Phone: 303-475-2102
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133VN1004X
TaxonomyPediatric Nutrition Registered Dietitian
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: