| Doctor Name: | KIMBERLY MACDERMOTT |
| NPI Number: | 1003240359 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | NP |
| License Number: | NP 0990840 |
| Business Practice Address: | 777 Bannock St Mc 0911 Denver, CO - 802044507 |
| Business Phone Number: | 3034368100 |
| Business Fax Number: | |
| Mailing Address: | 777 Bannock St, Mc 3240 DENVER |
| State: | CO |
| Postal Code: | 802044507 |
| Phone Number: | 3036022716 |
| Fax Number: | |
| NPI Enumeration Date: | 08/22/2013 |
| NPI Last Update Date: | 08/22/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LF0000X |
| License Number: | NP 0990840 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | CO |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Family |
| Taxonomy Definition: | |