Provider Demographics
NPI:1013266675
Name:WALKER, KIMBERLY DEMETRIOU (PA-C)
Entity Type:Individual
Prefix:MRS
First Name:KIMBERLY
Middle Name:DEMETRIOU
Last Name:WALKER
Suffix:
Gender:F
Credentials:PA-C
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Other - First Name:
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Mailing Address - Street 1:5445 DTC PKWY STE 1130
Mailing Address - Street 2:
Mailing Address - City:GREENWOOD VILLAGE
Mailing Address - State:CO
Mailing Address - Zip Code:80111-3038
Mailing Address - Country:US
Mailing Address - Phone:720-749-5599
Mailing Address - Fax:720-925-5897
Practice Address - Street 1:11990 GRANT ST STE 400
Practice Address - Street 2:
Practice Address - City:NORTHGLENN
Practice Address - State:CO
Practice Address - Zip Code:80233-1136
Practice Address - Country:US
Practice Address - Phone:720-749-5599
Practice Address - Fax:720-925-5897
Is Sole Proprietor?:Yes
Enumeration Date:2012-08-29
Last Update Date:2024-03-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
GA6556363A00000X, 363AM0700X
CO007892363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical