Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LA2200X | Nurse Practitioner - Adult Health | 0997194 | CO |
N | 363LG0600X | Nurse Practitioner - Gerontology | 0997194 | CO |
N | 363LW0102X | Nurse Practitioner - Women's Health | 0997194 | CO |
NPI | 1033863220 |
---|---|
Provider Name | Finihang Kakyemo |
First Address | Colorado Springs, CO 80920-7328 |
Second Address | Colorado Springs, CO 80920-7328 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 08/02/2022 |
Last Update Date | 08/02/2022 |