Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LC1500X | Nurse Practitioner - Community Health | 120872 | CO |
NPI | 1932308129 |
---|---|
Provider Name | Jody Lynn Kind |
First Address | Fort Collins, CO 80524-1681 |
Second Address | Fort Collins, CO 80524-2004 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/07/2007 |
Last Update Date | 17/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
39900576 | (05) | CO |