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General NPI Number Information
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NPI Number | 1629874888
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Entity Type | Individual
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Provider Name | KEVIN HAROLD PETERS
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Gender | Male
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Dates
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Enumeration Date | 02/19/2025
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Last Update Date | 02/19/2025
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Provider Practice Location Address
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Address Line | 4141 E DICKENSON PL
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City | DENVER
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State | CO
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Zip | 80222-6012
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Country | US
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Telephone | 303-504-6500
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Fax |
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Provider Business Mailing Address
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Address Line | 6266 S ALBION WAY
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City | CENTENNIAL
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State | CO
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Zip | 80121-3145
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Country | US
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Telephone | 720-484-1273
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Fax |
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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 | 171M00000X
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Taxonomy Name | Case Manager/Care Coordinator
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License Number |
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License Number State |
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