Provider Demographics
NPI:1386838720
Name:HASTINGS, KATHERINE J (OT)
Entity Type:Individual
Prefix:
First Name:KATHERINE
Middle Name:J
Last Name:HASTINGS
Suffix:
Gender:F
Credentials:OT
Other - Prefix:
Other - First Name:KATHERINE
Other - Middle Name:J
Other - Last Name:ZELLMER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OT
Mailing Address - Street 1:1130 W WOODMEN RD
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80919
Mailing Address - Country:US
Mailing Address - Phone:719-574-5562
Mailing Address - Fax:719-471-0445
Practice Address - Street 1:1130 W WOODMEN RD
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80919
Practice Address - Country:US
Practice Address - Phone:719-574-5562
Practice Address - Fax:719-471-0445
Is Sole Proprietor?:No
Enumeration Date:2007-08-29
Last Update Date:2011-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO1035265174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO01928228Medicaid
CO066637Medicare PIN