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MS. KATHLEEN ANN MOULDS FNP
Family >> Nurse Practitioner >> Physician Assistants & Advanced Practice Nursing ProvidersRegistrant NPI Number: 1457479370
Individual Registrant:MS. KATHLEEN ANN MOULDS FNP
Gender: F
Not Sole Proprietor
Gender: F
Not Sole Proprietor
Location and contact information for practice:
100 W 4TH ST WALSENBURG, CO 81089-1910 US
Tel: 719-738-1164 Fax: 719-738-3399
Tel: 719-738-1164 Fax: 719-738-3399
Contact information for business:
PO BOX 52 GARDNER, CO 81040-0052 US
Tel: 719-746-2069 Fax: 719-738-3399
Tel: 719-746-2069 Fax: 719-738-3399
Registration Information:
NPI: 1457479370
Entity Type: Individual
Entity Type: Individual
Specialty information:
| Primary | Code | Category/Description | State | License Number |
|---|---|---|---|---|
| Y | 363LF0000X | Physician Assistants & Advanced Practice Nursing Providers Nurse Practitioner Family | CO | 78274 |
Legacy codes, insurance codes and state license numbers:
| Issuer | Number | State | Type |
|---|---|---|---|
