Healthcare Provider Details

I. General information

NPI: 1952591901
Provider Name (Legal Business Name): KRISTIN ELAINE SHIPMAN M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/26/2007
Last Update Date: 01/24/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2055 N HIGH ST #370
DENVER CO
80205-5503
US

IV. Provider business mailing address

4900 S MONACO ST SUITE 210
DENVER CO
80237-3486
US

V. Phone/Fax

Practice location:
  • Phone: 303-839-6001
  • Fax: 303-839-6033
Mailing address:
  • Phone: 303-839-6001
  • Fax: 303-839-6033

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2086S0120X
TaxonomyPediatric Surgery Physician
License NumberM2100
License Number StateTX
# 2
Primary TaxonomyY
Taxonomy Code2086S0120X
TaxonomyPediatric Surgery Physician
License Number46850
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: