Healthcare Provider Details

I. General information

NPI: 1780267237
Provider Name (Legal Business Name): KRISTIN SIMONSON CNM, WHNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/03/2021
Last Update Date: 03/24/2024
Certification Date: 03/24/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1258 S PEARL ST STE 100
DENVER CO
80210-1538
US

IV. Provider business mailing address

1853 GARFIELD AVE
LOUISVILLE CO
80027-1364
US

V. Phone/Fax

Practice location:
  • Phone: 303-393-4330
  • Fax:
Mailing address:
  • Phone: 970-215-8103
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LW0102X
TaxonomyWomen's Health Nurse Practitioner
License NumberAPN.0996457-NP
License Number StateCO
# 2
Primary TaxonomyN
Taxonomy Code367A00000X
TaxonomyAdvanced Practice Midwife
License NumberAPN.0996480-CNM
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: