Provider Demographics
NPI:1477059939
Name:KLAMM, KATHRYN LUCILLE
Entity Type:Individual
Prefix:
First Name:KATHRYN
Middle Name:LUCILLE
Last Name:KLAMM
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2614 S DUNKIRK CT
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80013-7681
Mailing Address - Country:US
Mailing Address - Phone:920-540-4168
Mailing Address - Fax:
Practice Address - Street 1:2614 S DUNKIRK CT
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80013-7681
Practice Address - Country:US
Practice Address - Phone:920-540-4168
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-04-03
Last Update Date:2018-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COAPN-0.993458-NP363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily