Individual
MS. KIM H IRVING
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ANP
Contact information
Practice address
562 GREGORY STREET, BLACK HAWK, CO 80422
(303) 582-5276
(303) 582-1003
Mailing address
PO BOX 66, BLACK HAWK, CO 80422-0066
(303) 582-5276
(303) 582-1003
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
52786
CO
163WP2201X
Ambulatory Care Registered Nurse
Primary
RXN 97-125
CO
363LP2300X
Primary Care Nurse Practitioner
0001288
CO
Other
Enumeration date
08/17/2006
Last updated
07/31/2013
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