Provider Demographics
NPI:1558870840
Name:KATIAL, RENE C (NP)
Entity Type:Individual
Prefix:MRS
First Name:RENE
Middle Name:C
Last Name:KATIAL
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1881 BLUE SAGE LN
Mailing Address - Street 2:
Mailing Address - City:CASTLE ROCK
Mailing Address - State:CO
Mailing Address - Zip Code:80104-7888
Mailing Address - Country:US
Mailing Address - Phone:303-918-1414
Mailing Address - Fax:303-663-9493
Practice Address - Street 1:SUNCREST HOSPICE
Practice Address - Street 2:777 E. SPEER BLVD
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80203
Practice Address - Country:US
Practice Address - Phone:720-941-5580
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-09-29
Last Update Date:2017-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO106559163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse