1104060250 NPI number — MRS. KATHLEEN WHALEN MILLER NNP BC

Table of content: MRS. KATHLEEN WHALEN MILLER NNP BC (NPI 1104060250)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1104060250 NPI number — MRS. KATHLEEN WHALEN MILLER NNP BC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
MILLER
Provider First Name:
KATHLEEN
Provider Middle Name:
WHALEN
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
NNP BC
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
MILLER
Provider Other First Name:
KATHY
Provider Other Middle Name:
W
Provider Other Name Prefix Text:
MS.
Provider Other Name Suffix Text:
Provider Other Credential Text:
NNP BC (BSN)
Provider Other Last Name Type Code:
5

NPI Number Information

NPI Number:
1104060250
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
04/20/2009
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
8300 W 38TH AVE
Provider Second Line Business Mailing Address:
NICU
Provider Business Mailing Address City Name:
WHEAT RIDGE
Provider Business Mailing Address State Name:
CO
Provider Business Mailing Address Postal Code:
80033-6005
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
303-425-2217
Provider Business Mailing Address Fax Number:
303-425-8667

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
8300 W 38TH AVE
Provider Second Line Business Practice Location Address:
NICU
Provider Business Practice Location Address City Name:
WHEAT RIDGE
Provider Business Practice Location Address State Name:
CO
Provider Business Practice Location Address Postal Code:
80033-6005
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
303-425-2217
Provider Business Practice Location Address Fax Number:
303-425-8667
Provider Enumeration Date:
04/20/2009

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 363LN0005X , with the licence number:  49651 , registered in the state of CO ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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