Provider Demographics
NPI:1407163132
Name:BRANUM, KIM (BA)
Entity Type:Individual
Prefix:
First Name:KIM
Middle Name:
Last Name:BRANUM
Suffix:
Gender:F
Credentials:BA
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 300065
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80203-0065
Mailing Address - Country:US
Mailing Address - Phone:303-250-6732
Mailing Address - Fax:
Practice Address - Street 1:1634 DOWNING ST
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80218-1529
Practice Address - Country:US
Practice Address - Phone:303-504-1846
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-09-01
Last Update Date:2010-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator