Provider Demographics
NPI:1700044310
Name:SEXTON, KIMBERLY ANN (NP)
Entity Type:Individual
Prefix:
First Name:KIMBERLY
Middle Name:ANN
Last Name:SEXTON
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:KIMBERLY
Other - Middle Name:ANN
Other - Last Name:MERZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:4900 S MONACO ST
Mailing Address - Street 2:SUITE 210
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80237-3486
Mailing Address - Country:US
Mailing Address - Phone:303-481-0035
Mailing Address - Fax:303-752-5240
Practice Address - Street 1:1444 S POTOMAC ST
Practice Address - Street 2:SUITE 170
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80012-4508
Practice Address - Country:US
Practice Address - Phone:303-481-0035
Practice Address - Fax:303-752-5240
Is Sole Proprietor?:No
Enumeration Date:2008-05-30
Last Update Date:2013-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO114233363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
NM41134273Medicaid
ID1760794481Medicaid
KS200687960AMedicaid
CO69929327Medicaid
MT1700044310Medicaid
COCOA105110Medicaid
COCOA105110Medicaid
COP01141573Medicare PIN