Provider Demographics
NPI:1952591901
Name:SHIPMAN, KRISTIN ELAINE (MD)
Entity Type:Individual
Prefix:DR
First Name:KRISTIN
Middle Name:ELAINE
Last Name:SHIPMAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:4900 S MONACO ST
Mailing Address - Street 2:SUITE 210
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80237-3486
Mailing Address - Country:US
Mailing Address - Phone:303-839-6001
Mailing Address - Fax:303-839-6033
Practice Address - Street 1:2055 N HIGH ST
Practice Address - Street 2:#370
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80205-5503
Practice Address - Country:US
Practice Address - Phone:303-839-6001
Practice Address - Fax:303-839-6033
Is Sole Proprietor?:No
Enumeration Date:2007-07-26
Last Update Date:2022-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXM21002086S0120X
CO468502086S0120X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0120XAllopathic & Osteopathic PhysiciansSurgeryPediatric Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NM74350048Medicaid
NE10025770000Medicaid
MT1952531901Medicaid
CO53728301Medicaid
WY1952591901Medicaid
SD1952591901Medicaid