Provider Demographics
NPI:1255806196
Name:CLURE, KAITLYN (NP)
Entity type:Individual
Prefix:
First Name:KAITLYN
Middle Name:
Last Name:CLURE
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:906 GEENRIDGE LANE
Mailing Address - Street 2:
Mailing Address - City:CASTLE PINES
Mailing Address - State:CO
Mailing Address - Zip Code:80108
Mailing Address - Country:US
Mailing Address - Phone:720-884-7621
Mailing Address - Fax:
Practice Address - Street 1:6825 S GALENA ST STE 200
Practice Address - Street 2:
Practice Address - City:CENTENNIAL
Practice Address - State:CO
Practice Address - Zip Code:80112-3630
Practice Address - Country:US
Practice Address - Phone:303-741-0990
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-10-08
Last Update Date:2024-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO1624434163W00000X
CO0994362363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No163W00000XNursing Service ProvidersRegistered Nurse