Healthcare Provider Details

I. General information

NPI: 1619827599
Provider Name (Legal Business Name): KALEIA CHERIE WALDEN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/30/2026
Last Update Date: 06/19/2026
Certification Date: 06/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6200 W 9TH ST UNIT 1B
GREELEY CO
80634-4462
US

IV. Provider business mailing address

6200 W 9TH ST UNIT 1B
GREELEY CO
80634-4462
US

V. Phone/Fax

Practice location:
  • Phone: 970-353-5959
  • Fax:
Mailing address:
  • Phone: 970-353-5959
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number0009765
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: