Provider Demographics
NPI:1386658144
Name:VANSCRIVER, KIMBERLY PAULINE (MD)
Entity Type:Individual
Prefix:DR
First Name:KIMBERLY
Middle Name:PAULINE
Last Name:VANSCRIVER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:KIMBERLY
Other - Middle Name:PAULINE
Other - Last Name:VAN SCRIVER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:1805 SHEA CENTER DR STE 450
Mailing Address - Street 2:
Mailing Address - City:HIGHLANDS RANCH
Mailing Address - State:CO
Mailing Address - Zip Code:80129-2255
Mailing Address - Country:US
Mailing Address - Phone:303-738-1100
Mailing Address - Fax:303-738-1310
Practice Address - Street 1:7780 S BROADWAY
Practice Address - Street 2:SUITE 280
Practice Address - City:LITTLETON
Practice Address - State:CO
Practice Address - Zip Code:80122
Practice Address - Country:US
Practice Address - Phone:303-738-1100
Practice Address - Fax:303-738-1310
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-28
Last Update Date:2023-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CODR.00051657207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO99128306Medicaid
FL254762700Medicaid
CO99128306Medicaid
CO408392YUYJMedicare PIN