Basic Information
| Provider Information | |||||||||
| NPI: | 1760983332 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | ARAGON | ||||||||
| FirstName: | KIMBERLEE | ||||||||
| MiddleName: | ANN | ||||||||
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| Mailing Information | |||||||||
| Address1: | 9108 MADELEINE ST | ||||||||
| Address2: | |||||||||
| City: | FEDERAL HEIGHTS | ||||||||
| State: | CO | ||||||||
| PostalCode: | 802605190 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7203656065 | ||||||||
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| Practice Location | |||||||||
| Address1: | 975 NORTH ST | ||||||||
| Address2: | |||||||||
| City: | BOULDER | ||||||||
| State: | CO | ||||||||
| PostalCode: | 803043279 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3034438500 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 02/28/2018 | ||||||||
| LastUpdateDate: | 02/28/2018 | ||||||||
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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 | 175T00000X | 1854 | CO | Y |
No ID Information.