Individual
KRISTEN ELIZABETH ICKES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.O.
Contact information
Practice address
1835 FRANKLIN ST, DENVER, CO 80218-1126
(303) 338-4545
Mailing address
PO BOX 40000, VAIL, CO 81658-7520
(970) 476-2451
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
0116019715
VA
207R00000X
Internal Medicine Physician
Primary
49949
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
022032
KAISER COMMERCIAL NUMBER
CO
05
—
22650253
—
CO
Enumeration date
07/20/2007
Last updated
06/07/2021
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