Healthcare Provider Details

I. General information

NPI: 1295789543
Provider Name (Legal Business Name): KIMBERLY WIND NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/20/2006
Last Update Date: 10/08/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

601 E HAMPDEN AVE # 370
ENGLEWOOD CO
80113-3781
US

IV. Provider business mailing address

601 E HAMPDEN AVE # 370
ENGLEWOOD CO
80113-3781
US

V. Phone/Fax

Practice location:
  • Phone: 303-788-7888
  • Fax: 303-788-7592
Mailing address:
  • Phone: 303-788-7888
  • Fax: 303-788-7592

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LW0102X
TaxonomyWomen's Health Nurse Practitioner
License NumberRN 124319
License Number StateCO
# 2
Primary TaxonomyY
Taxonomy Code207VX0000X
TaxonomyObstetrics Physician
License Number4150
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: