Healthcare Provider Details

I. General information

NPI: 1750479200
Provider Name (Legal Business Name): JOSEPH ROBERT KAUFFMAN NP
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/10/2006
Last Update Date: 10/04/2021
Certification Date: 10/04/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1683 MAIN ST
WINDSOR CO
80550-7921
US

IV. Provider business mailing address

1683 MAIN ST
WINDSOR CO
80550-7921
US

V. Phone/Fax

Practice location:
  • Phone: 970-686-0124
  • Fax: 970-686-0845
Mailing address:
  • Phone: 970-686-0124
  • Fax: 970-686-0845

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LG0600X
TaxonomyGerontology Nurse Practitioner
License NumberAPN.0994298-NP
License Number StateCO

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: