Healthcare Provider Details

I. General information

NPI: 1275720658
Provider Name (Legal Business Name): KIMBERLY MICHELE WALKER N.P.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: KIMBERLY MICHELE AUGUSTUS NP-C

II. Dates (important events)

Enumeration Date: 09/28/2007
Last Update Date: 10/06/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6200 E. COLFAX AVE. HEALTHCARE CLINIC @ WALGREENS
DENVER CO
80220
US

IV. Provider business mailing address

1901 E VOORHEES ST. MS# 640- JAMIE MEDLEN
DANVILLE IL
61834
US

V. Phone/Fax

Practice location:
  • Phone: 720-695-3099
  • Fax: 303-377-3922
Mailing address:
  • Phone: 217-709-2204
  • Fax: 217-709-2345

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number0005308
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: