Provider Demographics
NPI:1346314770
Name:FARBER, KIMBERLY MARIE (APRN-BC)
Entity Type:Individual
Prefix:MRS
First Name:KIMBERLY
Middle Name:MARIE
Last Name:FARBER
Suffix:
Gender:F
Credentials:APRN-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10044 HANNIBAL ST
Mailing Address - Street 2:
Mailing Address - City:COMMERCE CITY
Mailing Address - State:CO
Mailing Address - Zip Code:80022-9369
Mailing Address - Country:US
Mailing Address - Phone:303-997-7660
Mailing Address - Fax:303-997-7660
Practice Address - Street 1:13120 E MISSISSIPPI AVE
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80012-3427
Practice Address - Country:US
Practice Address - Phone:720-282-3578
Practice Address - Fax:303-353-4206
Is Sole Proprietor?:No
Enumeration Date:2006-11-18
Last Update Date:2020-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO115260363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO40603032Medicaid
CO809268Medicare UPIN