Provider Demographics
NPI:1750479200
Name:KAUFFMAN, JOSEPH ROBERT (NP)
Entity Type:Individual
Prefix:
First Name:JOSEPH
Middle Name:ROBERT
Last Name:KAUFFMAN
Suffix:
Gender:M
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1683 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:WINDSOR
Mailing Address - State:CO
Mailing Address - Zip Code:80550-7921
Mailing Address - Country:US
Mailing Address - Phone:970-686-0124
Mailing Address - Fax:970-686-0845
Practice Address - Street 1:1683 MAIN ST
Practice Address - Street 2:
Practice Address - City:WINDSOR
Practice Address - State:CO
Practice Address - Zip Code:80550-7921
Practice Address - Country:US
Practice Address - Phone:970-686-0124
Practice Address - Fax:970-686-0845
Is Sole Proprietor?:No
Enumeration Date:2006-10-10
Last Update Date:2021-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COAPN.0994298-NP363LG0600X, 363LA2200X
GA7325111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Yes363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology
No111N00000XChiropractic ProvidersChiropractor