| Organization Name: | KINGFISHER FOUNDATION, INC. |
| NPI Number: | 1053633529 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | ROD DAWN GRABER (ADMINISTRATOR) |
| Mailing Address: | 209 Main Street Unit B Mead |
| State: | CO US |
| Postal Code: | 80542 |
| Phone Number: | 3034952166 |
| Fax Number: | 3033282304 |
| NPI Enumeration Date: | 02/24/2010 |
| NPI Last Update Date: | 05/04/2011 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LF0000X |
| License Number: | NP-10086 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | CO |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Family |
| Taxonomy Definition: | |