KELLY ROBIN WATERMAN


Address: 220 Flint Way, Broomfield, CO 80020-2250
Phone: 6513243680

KELLY ROBIN WATERMAN (NPI# 1306127618) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1306127618
Entity Type Individual
Full Name KELLY ROBIN WATERMAN
Credential CNIM
Practice Address 220 Flint Way
Broomfield
CO 80020-2250
Practice Telephone 6513243680
Mailing Telephone 6513243680
Mailing Fax Number 3039624819
Enumeration Date 2011-08-31
Last Update Date 2019-12-19
Gender Code F
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 246ZE0600X Specialist/Technologist, Other
Specialization: Electroneurodiagnostic
Technologists, Technicians & Other Technical Service Providers

Other Provider Identifier

State Issuer Identifier Type Code
CO ABRET CERTIFICATION 1200 01

Office Location

Street Address 220 FLINT WAY
City BROOMFIELD
State CO
Zip Code 80020-2250

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Taxonomy Information

Taxonomy Code 246ZE0600X
Grouping Technologists, Technicians & Other Technical Service Providers
Classification Specialist/Technologist, Other
Specialization Electroneurodiagnostic

Taxonomy Definition

Definition to come...

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1548792401 Breanna Singleton Specialist/Technologist, Other 280 E 1st Ave Unit 727, Broomfield, CO 80038-2229 2017-03-30
1134556939 Sns Technical Services, LLC Specialist/Technologist, Other 2205 W 136th Ave, Suite 106 #208, Broomfield, CO 80023-9306 2013-10-11
1720324254 M'lynn Gilliam Specialist/Technologist, Other 350 Interlocken Blvd Ste 360, Broomfield, CO 80021-8006 2013-01-03
1871838995 Jonathan P Vanderhamm Specialist/Technologist, Other 350 Interlocken Blvd, Suite 360, Broomfield, CO 80021-3477 2012-11-29
1962751289 Julianne E Bishop Specialist/Technologist, Other 350 Interlocken Blvd, Suite 360, Broomfield, CO 80021-3477 2012-08-31
1669733226 James P Nutt Specialist/Technologist, Other 350 Interlocken Blvd, Suite 360, Broomfield, CO 80021-3477 2012-05-30
1023388816 Kerstin Violet May-higgins Specialist/Technologist, Other 350 Interlocken Blvd, Ste 360, Broomfield, CO 80021-3477 2012-01-10
1467733527 Brian Lamar Ponder Specialist/Technologist, Other 350 Interlocken Blvd, Ste 360, Broomfield, CO 80021-3477 2011-09-02
1063711620 Haley Hinkle Specialist/Technologist, Other 350 Interlocken Blvd, Ste 360, Broomfield, CO 80021-3477 2011-03-22
1265737498 Irshad A Siddiqui Specialist/Technologist, Other 350 Interlocken Blvd, Ste 360, Broomfield, CO 80021-3477 2011-01-19
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Competitor

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City BROOMFIELD
Zip Code 80020

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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