Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207QH0002X | Family Doctor - Hospice and Palliative Medicine | DR0053849 | CO |
N | 2080P0203X | Pediatric Critical Care Doctor | DR0053849 | CO |
NPI | 1710066287 |
---|---|
Provider Name | Kimberly Statler Bennett |
First Address | Denver, CO 80230-7256 |
Second Address | Denver, CO 80230-7256 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/11/2006 |
Last Update Date | 14/05/2021 |