Provider Demographics
NPI:1730311176
Name:KALKWARF, DTHIA ALICE (REGISTERED NURSE)
Entity Type:Individual
Prefix:MS
First Name:DTHIA
Middle Name:ALICE
Last Name:KALKWARF
Suffix:
Gender:F
Credentials:REGISTERED NURSE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:52 PARADISE RD
Mailing Address - Street 2:
Mailing Address - City:GOLDEN
Mailing Address - State:CO
Mailing Address - Zip Code:80401-9458
Mailing Address - Country:US
Mailing Address - Phone:303-526-2217
Mailing Address - Fax:720-746-0350
Practice Address - Street 1:52 PARADISE RD
Practice Address - Street 2:
Practice Address - City:GOLDEN
Practice Address - State:CO
Practice Address - Zip Code:80401-9458
Practice Address - Country:US
Practice Address - Phone:303-526-2217
Practice Address - Fax:720-746-0350
Is Sole Proprietor?:Yes
Enumeration Date:2009-08-19
Last Update Date:2009-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO192076163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse