Provider Demographics
NPI:1740348432
Name:ATHERTON WOOD, KATHERINE (NP)
Entity type:Individual
Prefix:
First Name:KATHERINE
Middle Name:
Last Name:ATHERTON WOOD
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 1:3622 CLOVER CREEK LN
Mailing Address - Street 2:
Mailing Address - City:LONGMONT
Mailing Address - State:CO
Mailing Address - Zip Code:80503-6400
Mailing Address - Country:US
Mailing Address - Phone:303-587-5399
Mailing Address - Fax:
Practice Address - Street 1:2594 TRAILRIDGE DR E
Practice Address - Street 2:
Practice Address - City:LAFAYETTE
Practice Address - State:CO
Practice Address - Zip Code:80026-3186
Practice Address - Country:US
Practice Address - Phone:393-449-7740
Practice Address - Fax:303-604-5391
Is Sole Proprietor?:No
Enumeration Date:2006-12-05
Last Update Date:2025-04-18
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CO126270363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO126270OtherLICENSE