Provider Demographics
NPI:1003056276
Name:PEGAN, KATHRYN LYN (AUD)
Entity Type:Individual
Prefix:DR
First Name:KATHRYN
Middle Name:LYN
Last Name:PEGAN
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:MISS
Other - First Name:KATHRYN
Other - Middle Name:LYN
Other - Last Name:SCOTKA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:13123 E 16TH AVE
Mailing Address - Street 2:2ND FLOOR OUTPATIENT PAVILION - AUDIOLOGY
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80045-7106
Mailing Address - Country:US
Mailing Address - Phone:720-777-1961
Mailing Address - Fax:720-777-7169
Practice Address - Street 1:13123 E 16TH AVE
Practice Address - Street 2:2ND FLOOR OUTPATIENT PAVILION - AUDIOLOGY
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80045-7106
Practice Address - Country:US
Practice Address - Phone:720-777-1961
Practice Address - Fax:720-777-7169
Is Sole Proprietor?:No
Enumeration Date:2009-03-02
Last Update Date:2009-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL147001295231H00000X
CAAU2621231H00000X
CAHA7356237600000X
COAUD-573231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
No237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid Fitter