Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LN0000X | Nurse Practitioner - Neonatal | 3966 | CO |
NPI | 1154569408 |
---|---|
Provider Name | Mrs. Kathleen Weber |
First Address | Colorado Springs, CO 80923-2601 |
Second Address | Littleton, CO 80122-2602 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/01/2009 |
Last Update Date | 05/01/2022 |