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Individual

DEBORAH LEIGH KERN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
1000 ALPINE AVE, SUITE #100, BOULDER, CO 80304-3406
(303) 442-2150
(303) 442-3363
Mailing address
PO BOX 26666, PHS PROVIDER ENROLLMENT, ALBUQUERQUE, NM 87125-6666
(505) 923-6770
(505) 923-5354

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
37445
CO
207Q00000X
Family Medicine Physician
Primary
MD2008-0635
NM

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
23778377
CO
Enumeration date
09/01/2006
Last updated
07/09/2018
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