Provider Demographics
NPI:1568783207
Name:LETTOW, CATHERINE JO (CATHERINE LETTOW)
Entity Type:Individual
Prefix:
First Name:CATHERINE
Middle Name:JO
Last Name:LETTOW
Suffix:
Gender:F
Credentials:CATHERINE LETTOW
Other - Prefix:
Other - First Name:CATHERINE
Other - Middle Name:
Other - Last Name:LETTOW
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:CATHERINE LETTOW RN
Mailing Address - Street 1:8943 WALKER RD
Mailing Address - Street 2:
Mailing Address - City:LONGMONT
Mailing Address - State:CO
Mailing Address - Zip Code:80503-8688
Mailing Address - Country:US
Mailing Address - Phone:303-652-9944
Mailing Address - Fax:
Practice Address - Street 1:580 MOHAWK DR
Practice Address - Street 2:
Practice Address - City:BOULDER
Practice Address - State:CO
Practice Address - Zip Code:80303-3712
Practice Address - Country:US
Practice Address - Phone:303-614-1400
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-06-17
Last Update Date:2010-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO184524163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse