Provider Demographics
NPI:1295252781
Name:KUSTER, JAMES TRAVIS (APN)
Entity type:Individual
Prefix:
First Name:JAMES
Middle Name:TRAVIS
Last Name:KUSTER
Suffix:
Gender:M
Credentials:APN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4141 ARAPAHOE AVE STE 100
Mailing Address - Street 2:
Mailing Address - City:BOULDER
Mailing Address - State:CO
Mailing Address - Zip Code:80303-1032
Mailing Address - Country:US
Mailing Address - Phone:303-440-2277
Mailing Address - Fax:303-440-2353
Practice Address - Street 1:1100 BALSAM AVE FL 3
Practice Address - Street 2:
Practice Address - City:BOULDER
Practice Address - State:CO
Practice Address - Zip Code:80304-3404
Practice Address - Country:US
Practice Address - Phone:303-440-2277
Practice Address - Fax:303-440-2353
Is Sole Proprietor?:No
Enumeration Date:2017-08-24
Last Update Date:2023-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CORN.1627358163W00000X
COAPN.0993382-NP363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No163W00000XNursing Service ProvidersRegistered Nurse