Provider Demographics
NPI:1356508238
Name:MAY, KYLIE MARIE (PA-C)
Entity Type:Individual
Prefix:MISS
First Name:KYLIE
Middle Name:MARIE
Last Name:MAY
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:5445 DTC PKWY STE 1130
Mailing Address - Street 2:
Mailing Address - City:GREENWOOD VILLAGE
Mailing Address - State:CO
Mailing Address - Zip Code:80111-3038
Mailing Address - Country:US
Mailing Address - Phone:720-749-5599
Mailing Address - Fax:720-925-5897
Practice Address - Street 1:5920 S ESTES ST STE 220
Practice Address - Street 2:
Practice Address - City:LITTLETON
Practice Address - State:CO
Practice Address - Zip Code:80123-8619
Practice Address - Country:US
Practice Address - Phone:303-948-0734
Practice Address - Fax:720-925-5897
Is Sole Proprietor?:No
Enumeration Date:2008-05-19
Last Update Date:2024-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COPA.0002980363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO36773522Medicaid
CO36773522Medicaid