Individual
KIMBERLY DIRTH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA.0004038
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
025484
KAISER COMMERCIAL NUMBER
CO
05
—
63733285
—
CO
Enumeration date
11/04/2011
Last updated
08/23/2021
Update your record
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