Fredericksen, Kim Ann
Fredericksen, Kim Ann is an individual health care provider with primary practice located at 9191 Grant St. , Thornton CO 80229-8812. She recently has only one registered license in Allopathic & Osteopathic Physicians / Emergency Medicine, which is considered as her primary health care specialty. Fredericksen, Kim Ann can be contacted via phone (303) 450-4482.Contact Information
Primary practice address
9191 Grant St.
Thornton CO 80229-8812
Phone: (303) 450-4482
Fax: (303) 306-7753
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Emergency Medicine | 207P00000X | T4918 | Maryland |
| Allopathic & Osteopathic Physicians / Emergency Medicine | 207P00000X | DR.0046734 | Colorado |
Profile Details
| NPI number | 1528103843 |
|---|---|
| LBN Legal business name | Fredericksen, Kim Ann |
| Credentials | |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Feb 21st, 2007 |
| Last updated | Jun 25th, 2015 - about 9 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1528103843 | NPPES |
| Colorado | MEDICAID | 33455074 | |
| Colorado | Other | P00632056 |
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