Provider Demographics
NPI:1609903608
Name:BOGATAJ, KAREN MARIE (NP)
Entity Type:Individual
Prefix:MRS
First Name:KAREN
Middle Name:MARIE
Last Name:BOGATAJ
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 1:2551 W 84TH AVE
Mailing Address - Street 2:
Mailing Address - City:WESTMINSTER
Mailing Address - State:CO
Mailing Address - Zip Code:80031-3807
Mailing Address - Country:US
Mailing Address - Phone:303-561-5010
Mailing Address - Fax:303-561-5050
Practice Address - Street 1:2551 W 84TH AVE
Practice Address - Street 2:
Practice Address - City:WESTMINSTER
Practice Address - State:CO
Practice Address - Zip Code:80031-3807
Practice Address - Country:US
Practice Address - Phone:303-561-5010
Practice Address - Fax:303-561-5050
Is Sole Proprietor?:No
Enumeration Date:2007-02-27
Last Update Date:2017-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COAPN.0003984-NP363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
COP01401265OtherMCR RAILROAD
CO92989276Medicaid
CO92989276Medicaid
COQ37253Medicare UPIN