1386400877 NPI number — KATLYN BOLF FNP-BC

Table of content: KATLYN BOLF FNP-BC (NPI 1386400877)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1386400877 NPI number — KATLYN BOLF FNP-BC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
BOLF
Provider First Name:
KATLYN
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
FNP-BC
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1386400877
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
04/04/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
7951 E MAPLEWOOD AVE STE 350
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
GREENWOOD VILLAGE
Provider Business Mailing Address State Name:
CO
Provider Business Mailing Address Postal Code:
80111-4758
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
303-930-7895
Provider Business Mailing Address Fax Number:
832-601-6018

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
10107 RIDGEGATE PKWY STE 200
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
LONE TREE
Provider Business Practice Location Address State Name:
CO
Provider Business Practice Location Address Postal Code:
80124-5641
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
303-925-0700
Provider Business Practice Location Address Fax Number:
303-329-2599
Provider Enumeration Date:
02/22/2024

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: 363LF0000X , with the licence number:  APN.0999541-NP , 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)