Basic Information
| Provider Information | |||||||||
| NPI: | 1003861261 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | KLEIN | ||||||||
| FirstName: | ANN | ||||||||
| MiddleName: | T | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3965 S JERSEY ST | ||||||||
| Address2: | |||||||||
| City: | DENVER | ||||||||
| State: | CO | ||||||||
| PostalCode: | 802371141 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3038070648 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 7447 E BERRY AVE | ||||||||
| Address2: | 250 | ||||||||
| City: | GREENWOOD VILLAGE | ||||||||
| State: | CO | ||||||||
| PostalCode: | 801112146 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3037704227 | ||||||||
| FaxNumber: | 3037704231 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/24/2006 | ||||||||
| LastUpdateDate: | 07/01/2015 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | 39813 | CO | Y | Allopathic & Osteopathic Physicians | Family Medicine |
ID Information
| ID | Type | State | Issuer | Description | 82379033 | 05 | CO | MEDICAID | 012932 | 01 | CO | KAISER COMMERCIAL NUMBER | OTHER |