COLLEEN ANNE KILCULLEN (NPI# 1790179448) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1790179448 |
| Entity Type | Individual |
| Full Name | COLLEEN ANNE KILCULLEN |
| Credential | NP |
| Practice Address |
2101 Ken Pratt Blvd Ste 200 Longmont CO 80501 |
| Mailing Address |
Po Box 911057 Denver CO 80291-1057 |
| Practice Telephone | 3036493500 |
| Practice Fax Number | 3036493501 |
| Mailing Telephone | 8009530104 |
| Mailing Fax Number | 3037656640 |
| Enumeration Date | 2015-03-20 |
| Last Update Date | 2019-04-16 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LG0600X |
Nurse Practitioner Specialization: Gerontology |
APN.0091467 | CO | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CO | 97978353 | 05 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 2030 Mountain View Ave, Ste 300, Longmont, CO 805013178 | 7206528400 | 7206528415 |
| Street Address |
2101 KEN PRATT BLVD STE 200 |
| City | LONGMONT |
| State | CO |
| Zip Code | 80501 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922005651 | Susan Seydor Nelson | Registered Nurse | 2101 Ken Pratt Blvd Ste 200, Longmont, CO 80501-6568 | 2005-07-07 |
| 1184157588 | Danielle Trujillo | Family Medicine | 2101 Ken Pratt Blvd Ste 200, Longmont, CO 80501-6568 | 2017-04-04 |
| 1780047902 | Catholic Health Initiatives Colorado | Pediatrics | 2101 Ken Pratt Blvd Ste 200, Longmont, CO 80501-6568 | 2016-04-04 |
| 1851760557 | James W Sampson | Nurse Practitioner | 2101 Ken Pratt Blvd Ste 200, Longmont, CO 80501 | 2015-09-23 |
| 1740609866 | Alice Marie Vienneau | Social Worker | 2101 Ken Pratt Blvd Ste 200, Longmont, CO 80501-6568 | 2014-04-16 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598376774 | Boulder County Public Health | Public Health or Welfare | 515 Coffman Street, Suite 200, Longmont, CO 80501 | 2020-08-12 |
| 1164032827 | Kidstuff Child and Family Counseling, P.C. | Marriage & Family Therapist | 360 15th Ave, Ste. 104, Longmont, CO 80501 | 2020-08-06 |
| 1861036501 | Stateserv Medical of Colorado | Durable Medical Equipment & Medical Supplies | 63 South Pratt Pkwy, Landmont, CO 80501 | 2019-11-06 |
| 1558915090 | Array Clinical and Therapeutic Services | Assistant Behavior Analyst | 451 21st Ave. Suite B, Longmont, CO 80501 | 2019-08-01 |
| 1275195042 | Alisa Marie Schwegerl | Speech-Language Pathologist | 1800 Stroh Place, Longmont, CO 80501 | 2019-07-02 |
| 1295298545 | Jovahna Pena | Counselor | Behavioral Health Group, 850 23rd Ave Unit A, Longmont, CO 80501 | 2019-04-12 |
| 1659845568 | University Physicians Incorporated | Advanced Practice Midwife | 2030 Mountain View Ave Ste 400, Longmont, CO 80501 | 2019-01-14 |
| 1013404714 | Crafted Physical Therapy Pllc | Physical Therapist | 701 Delaware Ave Unit E, Longmont, CO 80501 | 2018-04-18 |
| 1588110860 | Randall Bonnom | Counselor | 420 21st Ave #113, Longmont, CO 80501 | 2016-08-28 |
| 1225401771 | Sowash Optometry Group, PC | Eyewear Supplier (Equipment, not the service) | 1242 S. Hover Street, Suite C200, Longmont, CO 80501 | 2015-11-05 |
| Find all providers in zip 80501 | ||||
| Taxonomy Code | 363LG0600X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Gerontology |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912504978 | Mary Margaret Krzystowczyk | Nurse Practitioner | 930 N Logan St Apt 1/2, Denver, CO 80203-3193 | 2020-10-02 |
| 1225635477 | Shannan Rene Bryant | Nurse Practitioner | 950 E Harvard Ave Ste 320, Denver, CO 80210-7005 | 2020-10-01 |
| 1902439029 | Michelle R Straight | Nurse Practitioner | 4141 Pony Tracks Dr, Colorado Springs, CO 80922-3065 | 2020-02-17 |
| 1295240380 | Audra Roosen | Nurse Practitioner | 1221 Timbervale Trl, Highlands Ranch, CO 80129-6946 | 2017-12-11 |
| 1134654916 | Jennifer Kahan | Nurse Practitioner | 18515 Peaceful Pines Rd, Monument, CO 80132-8368 | 2017-04-28 |
| 1376918722 | Rhiannon Lori Sunday | Nurse Practitioner | 8890 N. Union Blvd., Suite 185, Colorado Springs, CO 80920 | 2015-12-10 |
| 1467846600 | Cammie Rausch | Nurse Practitioner | 3885 Upham St Ste 100, Wheat Ridge, CO 80033-4800 | 2015-03-25 |
| 1992145734 | Stewart C Eldridge | Nurse Practitioner | 6947 Metropolitan St, Colorado Springs, CO 80911-2715 | 2013-06-25 |
| 1962745448 | Sarah Anne Hicks | Nurse Practitioner | 1265 S Broadway, Denver, CO 80210-1503 | 2013-04-03 |
| 1104102003 | Tricia Lea Vath | Nurse Practitioner | 8510 Bryant St Ste 350, Westminster, CO 80031-3845 | 2011-10-25 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.