Healthcare Provider Details

I. General information

NPI: 1003147984
Provider Name (Legal Business Name): KIM PATRICIA ANDERSON KIM ANDERSON RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: KIM PATRICIA THOMSON KIM THOMSON RN

II. Dates (important events)

Enumeration Date: 01/17/2010
Last Update Date: 01/17/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11245 HURON ST
WESTMINSTER CO
80234-2806
US

IV. Provider business mailing address

1011 ARAPAHOE CIR
LOUISVILLE CO
80027-1065
US

V. Phone/Fax

Practice location:
  • Phone: 303-338-4545
  • Fax:
Mailing address:
  • Phone: 303-720-0610
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WP0200X
TaxonomyPediatric Registered Nurse
License Number65871
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: