Provider Demographics
NPI:1225534860
Name:KIRT, ELIZABETH FAYE (FNP-C, PMHNP-BC)
Entity Type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:FAYE
Last Name:KIRT
Suffix:
Gender:F
Credentials:FNP-C, PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 727
Mailing Address - Street 2:
Mailing Address - City:CLARK
Mailing Address - State:CO
Mailing Address - Zip Code:80428-0727
Mailing Address - Country:US
Mailing Address - Phone:720-470-9124
Mailing Address - Fax:
Practice Address - Street 1:26810 NEPTUNE PLACE
Practice Address - Street 2:
Practice Address - City:CLARK
Practice Address - State:CO
Practice Address - Zip Code:80428
Practice Address - Country:US
Practice Address - Phone:970-810-1710
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-04-03
Last Update Date:2023-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COAPN.0993804-NP363LP2300X, 363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care