Provider Demographics
NPI:1659822930
Name:MASTERS, KATIE CALLENE (PA-C)
Entity Type:Individual
Prefix:MRS
First Name:KATIE
Middle Name:CALLENE
Last Name:MASTERS
Suffix:
Gender:F
Credentials:PA-C
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Mailing Address - Street 1:4386 TRAIL BOSS DR
Mailing Address - Street 2:
Mailing Address - City:CASTLE ROCK
Mailing Address - State:CO
Mailing Address - Zip Code:80104-7512
Mailing Address - Country:US
Mailing Address - Phone:303-688-8666
Mailing Address - Fax:303-688-8260
Practice Address - Street 1:4386 TRAIL BOSS DR
Practice Address - Street 2:
Practice Address - City:CASTLE ROCK
Practice Address - State:CO
Practice Address - Zip Code:80104
Practice Address - Country:US
Practice Address - Phone:303-688-8666
Practice Address - Fax:303-688-8260
Is Sole Proprietor?:No
Enumeration Date:2016-10-20
Last Update Date:2019-04-11
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CO0004784363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant