Basic Information
Provider Information
NPI: 1003101627
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: CHO
FirstName: KIOK
MiddleName:  
NamePrefix: MS.
NameSuffix:  
Credential: ANP-BC
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 3025 S PARKER RD STE 100
Address2:  
City: AURORA
State: CO
PostalCode: 800142914
CountryCode: US
TelephoneNumber: 3034817030
FaxNumber:  
Practice Location
Address1: 55 MADISON ST STE 355
Address2:  
City: DENVER
State: CO
PostalCode: 802065429
CountryCode: US
TelephoneNumber: 3033772020
FaxNumber:  
Other Information
ProviderEnumerationDate: 06/10/2011
LastUpdateDate: 06/23/2014
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: Y
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
363LA2200XNP-10005COY Physician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health

No ID Information.


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