Provider Demographics
NPI:1013978873
Name:MOURANI, KIMBERLY ANN (MD)
Entity type:Individual
Prefix:MRS
First Name:KIMBERLY
Middle Name:ANN
Last Name:MOURANI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:14001 E ILIFF AVE
Mailing Address - Street 2:STE 210
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80014-1405
Mailing Address - Country:US
Mailing Address - Phone:303-996-9601
Mailing Address - Fax:303-369-2605
Practice Address - Street 1:14001 E ILIFF AVE
Practice Address - Street 2:STE 210
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80014-1405
Practice Address - Country:US
Practice Address - Phone:303-996-9601
Practice Address - Fax:303-369-2605
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-31
Last Update Date:2021-01-12
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CO35990208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO01359900Medicaid