1356621627 NPI number — DR. KATHRYN MARGARET BENES PH.D.

Table of content: DR. KATHRYN MARGARET BENES PH.D. (NPI 1356621627)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1356621627 NPI number — DR. KATHRYN MARGARET BENES PH.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
BENES
Provider First Name:
KATHRYN
Provider Middle Name:
MARGARET
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
PH.D.
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
TRENTHAM
Provider Other First Name:
KATHRYN
Provider Other Middle Name:
MARGARET
Provider Other Name Prefix Text:
MISS
Provider Other Name Suffix Text:
Provider Other Credential Text:
B.S.
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1356621627
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
08/18/2011
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
4045 PECOS STREET
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
DENVER
Provider Business Mailing Address State Name:
CO
Provider Business Mailing Address Postal Code:
80211-2552
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
720-377-1359
Provider Business Mailing Address Fax Number:
303-742-1181

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
4045 PECOS STREET
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
DENVER
Provider Business Practice Location Address State Name:
CO
Provider Business Practice Location Address Postal Code:
80211-2552
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
720-377-1359
Provider Business Practice Location Address Fax Number:
303-742-1181
Provider Enumeration Date:
08/18/2011

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: 103T00000X , with the licence number:  3535 , 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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