Basic Information
| Provider Information | |||||||||
| NPI: | 1457746216 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | CULLEN | ||||||||
| FirstName: | KIMBERLY | ||||||||
| MiddleName: | ANN | ||||||||
| NamePrefix: | MS. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1700 N MARION ST | ||||||||
| Address2: | |||||||||
| City: | DENVER | ||||||||
| State: | CO | ||||||||
| PostalCode: | 802181121 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3038607770 | ||||||||
| FaxNumber: | 3038607775 | ||||||||
| Practice Location | |||||||||
| Address1: | 1700 N MARION ST | ||||||||
| Address2: | |||||||||
| City: | DENVER | ||||||||
| State: | CO | ||||||||
| PostalCode: | 802181121 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3038607770 | ||||||||
| FaxNumber: | 3038607775 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/30/2015 | ||||||||
| LastUpdateDate: | 10/08/2019 | ||||||||
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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 | DR.0061033 | CO | Y | Allopathic & Osteopathic Physicians | Family Medicine |
No ID Information.