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General NPI Number Information
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NPI Number | 1922400225
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Entity Type | Individual
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Provider Name | KIMBERLY PAINE NP-C
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Gender | Female
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Dates
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Enumeration Date | 09/18/2014
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Last Update Date | 11/01/2022
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Provider Practice Location Address
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Address Line | 2350 MEADOWS BLVD
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City | CASTLE ROCK
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State | CO
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Zip | 80109-8405
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Country | US
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Telephone | 720-455-0655
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Fax | 720-455-0065
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Provider Business Mailing Address
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Address Line | PO BOX 173891
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City | DENVER
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State | CO
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Zip | 80217-3891
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Country | US
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Telephone | 303-306-7783
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Fax | 303-306-7753
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 0991329-NP
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License Number State | CO
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