Provider Demographics
NPI:1457511560
Name:COLLINS, KATHLEEN D (MD)
Entity Type:Individual
Prefix:
First Name:KATHLEEN
Middle Name:D
Last Name:COLLINS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:13701 W JEWELL AVE
Mailing Address - Street 2:STE 260
Mailing Address - City:LAKEWOOD
Mailing Address - State:CO
Mailing Address - Zip Code:80228-4139
Mailing Address - Country:US
Mailing Address - Phone:303-989-8039
Mailing Address - Fax:303-989-8056
Practice Address - Street 1:13701 W JEWELL AVE
Practice Address - Street 2:STE 260
Practice Address - City:LAKEWOOD
Practice Address - State:CO
Practice Address - Zip Code:80228-4139
Practice Address - Country:US
Practice Address - Phone:303-989-8039
Practice Address - Fax:303-989-8056
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-11
Last Update Date:2008-06-11
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CO246352084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
COE83042Medicare UPIN
CO19431Medicare PIN