Provider Demographics
NPI:1790998755
Name:KLAREN, KATRINA MARTA (PA - C)
Entity Type:Individual
Prefix:MS
First Name:KATRINA
Middle Name:MARTA
Last Name:KLAREN
Suffix:
Gender:F
Credentials:PA - C
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1046 SAGEBRUSH WAY
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:CO
Mailing Address - Zip Code:80027-1641
Mailing Address - Country:US
Mailing Address - Phone:303-666-6099
Mailing Address - Fax:
Practice Address - Street 1:2255 S 88TH ST
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:CO
Practice Address - Zip Code:80027-9716
Practice Address - Country:US
Practice Address - Phone:303-666-2095
Practice Address - Fax:303-666-1801
Is Sole Proprietor?:No
Enumeration Date:2007-05-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CO2302363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant