Provider Demographics
NPI:1932982337
Name:ALBERTSEN, KACIE LYNNE (DNP, APRN)
Entity type:Individual
Prefix:
First Name:KACIE
Middle Name:LYNNE
Last Name:ALBERTSEN
Suffix:
Gender:F
Credentials:DNP, APRN
Other - Prefix:
Other - First Name:KACIE
Other - Middle Name:LYNNE
Other - Last Name:FALLOT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:4745 ARAPAHOE AVE STE 130
Mailing Address - Street 2:
Mailing Address - City:BOULDER
Mailing Address - State:CO
Mailing Address - Zip Code:80303-1082
Mailing Address - Country:US
Mailing Address - Phone:303-443-2771
Mailing Address - Fax:
Practice Address - Street 1:4745 ARAPAHOE AVE STE 130
Practice Address - Street 2:
Practice Address - City:BOULDER
Practice Address - State:CO
Practice Address - Zip Code:80303-1082
Practice Address - Country:US
Practice Address - Phone:303-443-2771
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-08-17
Last Update Date:2024-12-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO1000390363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care