Provider Demographics
NPI:1851421796
Name:CRAPEAU, KIMBERLY A (RN)
Entity Type:Individual
Prefix:
First Name:KIMBERLY
Middle Name:A
Last Name:CRAPEAU
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2037 JERRY MURPHY RD STE 200
Mailing Address - Street 2:
Mailing Address - City:PUEBLO
Mailing Address - State:CO
Mailing Address - Zip Code:81001-1206
Mailing Address - Country:US
Mailing Address - Phone:719-281-3450
Mailing Address - Fax:303-360-1592
Practice Address - Street 1:2037 JERRY MURPHY RD STE 200
Practice Address - Street 2:
Practice Address - City:PUEBLO
Practice Address - State:CO
Practice Address - Zip Code:81001-1206
Practice Address - Country:US
Practice Address - Phone:719-281-3450
Practice Address - Fax:719-281-3454
Is Sole Proprietor?:No
Enumeration Date:2007-03-07
Last Update Date:2020-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO0995192363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
016761OtherKAISER-COMMERCIAL NUMBER