Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208000000X | Pediatrician | 33836 | CO |
NPI | 1013066216 |
---|---|
Provider Name | Dr. Kathryn K. Starbuck |
First Address | Broomfield, CO 80020-7921 |
Second Address | Broomfield, CO 80020-7921 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/01/2007 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1338367 | (05) | CO |
F86552 | (02) |