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MS. KATHLEEN ANN MOULDS FNP

Family >> Nurse Practitioner >> Physician Assistants & Advanced Practice Nursing Providers

Registrant NPI Number: 1457479370

Individual Registrant:
MS. KATHLEEN ANN MOULDS FNP
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

Contact information for business:
PO BOX 52  GARDNER, CO 81040-0052 US
Tel: 719-746-2069  Fax: 719-738-3399

Registration Information:
NPI: 1457479370
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y363LF0000XPhysician Assistants & Advanced Practice Nursing Providers
Nurse Practitioner
Family
CO78274

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType




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