Healthcare Provider Details

I. General information

NPI: 1255272498
Provider Name (Legal Business Name): ISABELLE KORNBERG
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/02/2026
Last Update Date: 04/02/2026
Certification Date: 04/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8820 HURON ST
THORNTON CO
80260-6805
US

IV. Provider business mailing address

8820 HURON ST
THORNTON CO
80260-6805
US

V. Phone/Fax

Practice location:
  • Phone: 303-386-7622
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN.1687730
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: