Individual
KELLY ROBIN WATERMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CNIM
Contact information
Practice address
220 FLINT WAY, BROOMFIELD, CO 80020-2250
(651) 324-3680
Mailing address
220 FLINT WAY, BROOMFIELD, CO 80020-2250
(651) 324-3680
(303) 962-4819
Taxonomy
Speciality
Code
Description
License number
State
246ZE0600X
Electroneurodiagnostic Specialist/Technologist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1200
ABRET CERTIFICATION
CO
Enumeration date
08/31/2011
Last updated
12/19/2019
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