Basic Information
| Provider Information | |||||||||
| NPI: | 1174918346 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | BEUKEMA | ||||||||
| FirstName: | KYLIE | ||||||||
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| Mailing Information | |||||||||
| Address1: | 14300 ORCHARD PKWY | ||||||||
| Address2: | |||||||||
| City: | WESTMINSTER | ||||||||
| State: | CO | ||||||||
| PostalCode: | 800239206 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3034305560 | ||||||||
| FaxNumber: | 3034305565 | ||||||||
| Practice Location | |||||||||
| Address1: | 14300 ORCHARD PKWY | ||||||||
| Address2: | |||||||||
| City: | WESTMINSTER | ||||||||
| State: | CO | ||||||||
| PostalCode: | 800239206 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3034305560 | ||||||||
| FaxNumber: | 3034305565 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/03/2015 | ||||||||
| LastUpdateDate: | 07/09/2018 | ||||||||
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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 | 207Q00000X | TL0005520 | CO | N | Allopathic & Osteopathic Physicians | Family Medicine | 207Q00000X | DR.0057546 | CO | Y | Allopathic & Osteopathic Physicians | Family Medicine |
No ID Information.