Basic Information
Provider Information
NPI: 1467665281
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: KALERT
FirstName: LYNN
MiddleName: B
NamePrefix: MS.
NameSuffix:  
Credential: FNP-C
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 5920 MCINTYRE ST
Address2:  
City: GOLDEN
State: CO
PostalCode: 804037445
CountryCode: US
TelephoneNumber: 3039491250
FaxNumber:  
Practice Location
Address1: 5920 MCINTYRE ST
Address2:  
City: GOLDEN
State: CO
PostalCode: 804037445
CountryCode: US
TelephoneNumber: 3039491250
FaxNumber:  
Other Information
ProviderEnumerationDate: 05/08/2007
LastUpdateDate: 01/21/2016
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
163WC1400X63743CON Nursing Service ProvidersRegistered NurseCollege Health
363LF0000X990214COY Physician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily

No ID Information.


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