Provider Demographics
NPI:1588651806
Name:SMITH, KATHERINE DUCHEN (RN MS CPNP)
Entity Type:Individual
Prefix:MS
First Name:KATHERINE
Middle Name:DUCHEN
Last Name:SMITH
Suffix:
Gender:F
Credentials:RN MS CPNP
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Mailing Address - Street 1:1625 COUNTRY CLUB RD
Mailing Address - Street 2:
Mailing Address - City:FORT COLLINS
Mailing Address - State:CO
Mailing Address - Zip Code:80524-1982
Mailing Address - Country:US
Mailing Address - Phone:970-221-0157
Mailing Address - Fax:970-482-4560
Practice Address - Street 1:315 CANYON AVE
Practice Address - Street 2:SUITE A
Practice Address - City:FORT COLLINS
Practice Address - State:CO
Practice Address - Zip Code:80521-2677
Practice Address - Country:US
Practice Address - Phone:970-482-2136
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-10-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CO64219363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics