Provider Demographics
NPI:1073826459
Name:TERRILL, KATHRYN ANN (MSN, PMHCNS-BC, RXN)
Entity Type:Individual
Prefix:MS
First Name:KATHRYN
Middle Name:ANN
Last Name:TERRILL
Suffix:
Gender:F
Credentials:MSN, PMHCNS-BC, RXN
Other - Prefix:
Other - First Name:KATHRYN
Other - Middle Name:ANN
Other - Last Name:TERRILL-TORREZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MSN, PMHCNS-BC, RXN
Mailing Address - Street 1:90 MADISON STREET
Mailing Address - Street 2:SUITE 102
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80206-5150
Mailing Address - Country:US
Mailing Address - Phone:720-331-6899
Mailing Address - Fax:720-306-5499
Practice Address - Street 1:90 MADISON STREET
Practice Address - Street 2:SUITE 102
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80206-5418
Practice Address - Country:US
Practice Address - Phone:720-331-6899
Practice Address - Fax:720-306-5499
Is Sole Proprietor?:No
Enumeration Date:2010-07-14
Last Update Date:2018-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO74752-2820364SP0809X, 364SP0811X, 364SP0813X, 364S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364S00000XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse Specialist
No364SP0809XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistPsychiatric/Mental Health, Adult
No364SP0811XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistPsychiatric/Mental Health, Chronically Ill
No364SP0813XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistPsychiatric/Mental Health, Geropsychiatric