Individual
DR. MICHELLE MARIE KLISMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
15909 JACKSON CREEK PKWY, MONUMENT, CO 80132-8693
(719) 522-1133
(719) 481-1620
Mailing address
PO BOX 35380, LAS VEGAS, NV 89133-5380
(702) 579-3203
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
DR.0053709
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200111620A
—
OK
05
—
81177836
—
CO
Enumeration date
10/20/2006
Last updated
04/22/2026
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