Provider Demographics
NPI:1225877210
Name:LOMAX, KIMBERLY D (RN, CCM)
Entity type:Individual
Prefix:
First Name:KIMBERLY
Middle Name:D
Last Name:LOMAX
Suffix:
Gender:F
Credentials:RN, CCM
Other - Prefix:
Other - First Name:KIMBERLY
Other - Middle Name:D
Other - Last Name:DYSON-LOMAX
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:RN, CCM
Mailing Address - Street 1:1250 S BUCKLEY RD UNIT I-247
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80017-4180
Mailing Address - Country:US
Mailing Address - Phone:303-736-8138
Mailing Address - Fax:303-736-8283
Practice Address - Street 1:445 S AIRPORT BLVD
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80017-2123
Practice Address - Country:US
Practice Address - Phone:443-322-6488
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-05-21
Last Update Date:2024-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO04YJXB3747P1801X, 374U00000X, 376J00000X, 251J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251J00000XAgenciesNursing Care
No3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant
No374U00000XNursing Service Related ProvidersHome Health Aide
No376J00000XNursing Service Related ProvidersHomemaker