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).
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 |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 246ZE0600X |
Specialist/Technologist, Other Specialization: Electroneurodiagnostic |
Technologists, Technicians & Other Technical Service Providers |
State | Issuer | Identifier | Type Code |
---|---|---|---|
CO | ABRET CERTIFICATION | 1200 | 01 |
Street Address |
220 FLINT WAY |
City | BROOMFIELD |
State | CO |
Zip Code | 80020-2250 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1487210993 | Terri Lynn Rist | Day Training, Developmentally Disabled Services | 12161 Crabapple Street, Broomfield, CO 80020 | 2019-05-10 |
1063984409 | This Is Massage | Registered Nurse | 2625 W 133rd Circle Dr., Broomfield Co, CO 80020 | 2018-12-26 |
1588187678 | Jenny St. Claire | Counselor | 80 Garden Ctr Ste 140, Broomfield, CO 80020 | 2017-07-20 |
1649791880 | Brett T Nelson | Dentist | 340 East 1st Avenue, Suite 202, Broomfield, CO 80020 | 2017-06-28 |
1073033411 | Patrice S Lensmire Gauthier | Occupational Therapist | 12970 Sheridan Blvd, Broomfield, CO 80020 | 2017-06-27 |
1871047753 | Michelle L Fussnecker | Physician Assistant | 6450 W 120th Ave Unit A, Broomfield, CO 80020 | 2016-08-09 |
1588029565 | Courtney Miller | Marriage & Family Therapist | 26 Garden Center Suite 1, Broomfield, CO 80020 | 2015-12-17 |
1659742161 | Heather Scott | Physician Assistant | 340 E 1st Ave Ste 100, Broomfield, CO 80020 | 2015-10-09 |
1154701407 | Emily Arrington | Speech-Language Pathologist | 1790 W 6th Ave, Broomfield, CO 80020 | 2015-06-02 |
1376939884 | Retro Dental Group Broomfield | Dentist | 5105 120th Ave, Broomfield, CO 80020 | 2015-04-10 |
Find all providers in zip 80020 |
Taxonomy Code | 246ZE0600X |
Grouping | Technologists, Technicians & Other Technical Service Providers |
Classification | Specialist/Technologist, Other |
Specialization | Electroneurodiagnostic |
Definition to come... |
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 |
Find all providers in BROOMFIELD |
City | BROOMFIELD |
Zip Code | 80020 |
Please comment or provide details below to improve the information on KELLY ROBIN WATERMAN.
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.