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General NPI Number Information
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NPI Number | 1780550186
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Entity Type | Individual
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Provider Name | KENZIE TARYN MCCABE NP
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Gender | Female
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Dates
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Enumeration Date | 10/13/2025
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Last Update Date | 10/13/2025
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Provider Practice Location Address
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Address Line | 240 S ELIZABETH ST UNIT 103
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City | ELIZABETH
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State | CO
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Zip | 80107-7546
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Country | US
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Telephone | 262-989-6647
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Fax |
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Provider Business Mailing Address
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Address Line | 3884 SANDY VISTA TRL
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City | CASTLE ROCK
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State | CO
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Zip | 80104-3517
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Country | US
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Telephone | 262-989-6647
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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 | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | APN.1001298-NP
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License Number State | CO
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