Healthcare Provider Details

I. General information

NPI: 1962266627
Provider Name (Legal Business Name): KAITY BARKER-GRASSER FNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/12/2024
Last Update Date: 10/10/2024
Certification Date: 10/10/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

730 N SUMMIT BLVD STE 101
FRISCO CO
80443-5958
US

IV. Provider business mailing address

356 BUCKEYE CREEK RD
LEADVILLE CO
80461-9314
US

V. Phone/Fax

Practice location:
  • Phone: 970-668-1616
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number0999945
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: