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Individual

KAITLYN ELIZABETH RUNNELS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
RN

Contact information

Practice address
1801 16TH ST, GREELEY, CO 80631-5199
(970) 810-4121
Mailing address
1801 16TH ST, GREELEY, CO 80631-5199
(970) 810-4121

Taxonomy

Speciality
Code
Description
License number
State
163WN0002X
Neonatal Intensive Care Registered Nurse
1617123
CO
363LN0000X
Neonatal Nurse Practitioner
Primary
0994847-NP
CO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0994847-NP
APN LICENSE
CO
05
1013573997
CO
01
1617123
RN LICENSE
CO
Enumeration date
05/15/2019
Last updated
11/20/2019
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