Provider Demographics
NPI:1356628226
Name:GIBBONS, KATHERINE B (PHD)
Entity Type:Individual
Prefix:DR
First Name:KATHERINE
Middle Name:B
Last Name:GIBBONS
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:6093 S QUEBEC ST STE 203
Mailing Address - Street 2:
Mailing Address - City:CENTENNIAL
Mailing Address - State:CO
Mailing Address - Zip Code:80111-4544
Mailing Address - Country:US
Mailing Address - Phone:303-220-7906
Mailing Address - Fax:303-220-7907
Practice Address - Street 1:6093 S QUEBEC ST STE 203
Practice Address - Street 2:
Practice Address - City:CENTENNIAL
Practice Address - State:CO
Practice Address - Zip Code:80111-4544
Practice Address - Country:US
Practice Address - Phone:303-220-7906
Practice Address - Fax:303-220-7907
Is Sole Proprietor?:Yes
Enumeration Date:2011-11-07
Last Update Date:2011-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133N00000XDietary & Nutritional Service ProvidersNutritionist