Provider Demographics
NPI:1346684016
Name:WELLS, KATHERINE TRUETTNER (DO)
Entity Type:Individual
Prefix:
First Name:KATHERINE
Middle Name:TRUETTNER
Last Name:WELLS
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:KATHERINE
Other - Middle Name:MILES
Other - Last Name:TRUETTNER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DO
Mailing Address - Street 1:821 MADISON ST.
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80206
Mailing Address - Country:US
Mailing Address - Phone:303-594-5109
Mailing Address - Fax:
Practice Address - Street 1:821 MADISON ST.
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80206
Practice Address - Country:US
Practice Address - Phone:303-594-5109
Practice Address - Fax:720-974-7175
Is Sole Proprietor?:Yes
Enumeration Date:2013-04-24
Last Update Date:2019-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CODR.0056456208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics