Provider Demographics
NPI:1760189823
Name:MCKINLEY, KIMBERLY SMITH (FNP)
Entity Type:Individual
Prefix:
First Name:KIMBERLY
Middle Name:SMITH
Last Name:MCKINLEY
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14991 E HAMPDEN AVE STE 110
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80014-3980
Mailing Address - Country:US
Mailing Address - Phone:303-343-9500
Mailing Address - Fax:
Practice Address - Street 1:14991 E HAMPDEN AVE STE 110
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80014-3980
Practice Address - Country:US
Practice Address - Phone:303-343-9500
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-02-09
Last Update Date:2023-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COANP.0998258363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily