Provider Demographics
NPI:1710298484
Name:STOREY, KIRSTEN (DO)
Entity Type:Individual
Prefix:DR
First Name:KIRSTEN
Middle Name:
Last Name:STOREY
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:702A W DRAKE RD
Mailing Address - Street 2:
Mailing Address - City:FORT COLLINS
Mailing Address - State:CO
Mailing Address - Zip Code:80526-5521
Mailing Address - Country:US
Mailing Address - Phone:970-229-4600
Mailing Address - Fax:970-229-4699
Practice Address - Street 1:702A W DRAKE RD
Practice Address - Street 2:
Practice Address - City:FORT COLLINS
Practice Address - State:CO
Practice Address - Zip Code:80526-5521
Practice Address - Country:US
Practice Address - Phone:970-229-4600
Practice Address - Fax:970-229-4699
Is Sole Proprietor?:No
Enumeration Date:2010-06-28
Last Update Date:2014-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CODR.0054256207R00000X, 208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208000000XAllopathic & Osteopathic PhysiciansPediatrics