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General NPI Number Information
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NPI Number | 1245304252
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Entity Type | Individual
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Provider Name | LISA CHRISTINE KILPATRICK PA-C
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Gender | Female
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Dates
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Enumeration Date | 11/20/2006
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Last Update Date | 09/30/2024
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Provider Practice Location Address
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Address Line | 340 E 1ST AVE STE 102
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City | BROOMFIELD
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State | CO
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Zip | 80020-2454
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Country | US
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Telephone | 720-798-0170
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Fax | 303-862-7102
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Provider Business Mailing Address
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Address Line | 1805 SHEA CENTER DR STE 450
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City | HIGHLANDS RANCH
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State | CO
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Zip | 80129-2255
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Country | US
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Telephone | 303-357-2559
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Fax | 303-862-7102
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number | PA2006 0041
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License Number State | NM
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Taxonomy #2
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 3140
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License Number State | CO
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