Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207Q00000X | Family Doctor | 35.091097 | OH |
N | 207Q00000X | Family Doctor | DR.0044846 | CO |
NPI | 1003019043 |
---|---|
Provider Name | Dr. Kathryn Burkhardt Goeke |
First Address | Lakewood, CO 80228-1527 |
Second Address | Lakewood, CO 80228-1527 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/06/2007 |
Last Update Date | 11/04/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
2901828 | (05) | OH |
44024720 | (05) | CO |