=====================================================
General NPI Number Information
=====================================================
NPI Number | 1154981462
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | KACI LYN DAY NP
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 06/18/2019
-----------------------------------------------------
Last Update Date | 11/09/2023
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 3801 E FLORIDA AVE STE 300
-----------------------------------------------------
City | DENVER
-----------------------------------------------------
State | CO
-----------------------------------------------------
Zip | 80210-2571
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 303-388-4256
-----------------------------------------------------
Fax | 303-388-7802
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | PO BOX 17982
-----------------------------------------------------
City | BELFAST
-----------------------------------------------------
State | ME
-----------------------------------------------------
Zip | 04915-4074
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 303-388-4256
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 363LP0200X
-----------------------------------------------------
Taxonomy Name | Pediatric Nurse Practitioner
-----------------------------------------------------
License Number | APN.0994587-NP
-----------------------------------------------------
License Number State | CO
-----------------------------------------------------