Provider Demographics
NPI:1780720441
Name:MCKITTERICK, CHERRIE MARIE (MD)
Entity type:Individual
Prefix:DR
First Name:CHERRIE
Middle Name:MARIE
Last Name:MCKITTERICK
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 35380
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89133-5380
Mailing Address - Country:US
Mailing Address - Phone:719-463-5600
Mailing Address - Fax:
Practice Address - Street 1:2230 S FRASER ST UNIT 1
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80014-4536
Practice Address - Country:US
Practice Address - Phone:303-341-4200
Practice Address - Fax:303-341-4480
Is Sole Proprietor?:No
Enumeration Date:2007-01-29
Last Update Date:2025-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO34812207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO028804OtherKAISER COMMERCIAL NUMBER
CO01348127Medicaid
84384Medicare ID - Type Unspecified