Provider Demographics
NPI:1538333711
Name:KROEGER-WEEKS, KIMBERLY L (MS, MS OTR/L)
Entity type:Individual
Prefix:
First Name:KIMBERLY
Middle Name:L
Last Name:KROEGER-WEEKS
Suffix:
Gender:F
Credentials:MS, MS OTR/L
Other - Prefix:
Other - First Name:KIMBERLY
Other - Middle Name:L
Other - Last Name:KROEGER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:390 BERYL ST
Mailing Address - Street 2:
Mailing Address - City:BROOMFIELD
Mailing Address - State:CO
Mailing Address - Zip Code:80020-1928
Mailing Address - Country:US
Mailing Address - Phone:303-681-6417
Mailing Address - Fax:
Practice Address - Street 1:395 S PRATT PKWY
Practice Address - Street 2:
Practice Address - City:LONGMONT
Practice Address - State:CO
Practice Address - Zip Code:80501-6436
Practice Address - Country:US
Practice Address - Phone:303-494-3961
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-04-17
Last Update Date:2023-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
234247225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist