Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | A115350 | CA |
N | 2084N0402X | Child Neurologist | 0061537 | CO |
N | 2084N0402X | Child Neurologist | 2012021750 | MO |
N | 2084N0402X | Child Neurologist | A115350 | CA |
Y | 2084N0402X | Child Neurologist | DR.0061537 | CO |
NPI | 1134424963 |
---|---|
Provider Name | Katharine Meddles |
First Address | Denver, CO 80205-5507 |
Second Address | Denver, CO 80205-5507 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 26/01/2011 |
Last Update Date | 27/09/2019 |