Provider Demographics
NPI:1356680771
Name:WESTOVER, KATHY ANN (RN)
Entity Type:Individual
Prefix:
First Name:KATHY
Middle Name:ANN
Last Name:WESTOVER
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:112 W 5TH ST
Mailing Address - Street 2:
Mailing Address - City:LEADVILLE
Mailing Address - State:CO
Mailing Address - Zip Code:80461-3510
Mailing Address - Country:US
Mailing Address - Phone:719-486-2413
Mailing Address - Fax:719-486-4179
Practice Address - Street 1:112 W 5TH ST
Practice Address - Street 2:
Practice Address - City:LEADVILLE
Practice Address - State:CO
Practice Address - Zip Code:80461-3510
Practice Address - Country:US
Practice Address - Phone:719-486-2413
Practice Address - Fax:719-486-4179
Is Sole Proprietor?:Yes
Enumeration Date:2013-02-05
Last Update Date:2013-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO203017251K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251K00000XAgenciesPublic Health or Welfare