Provider Demographics
NPI:1952670754
Name:SPIGHT, KATHRYN E (PA-C)
Entity Type:Individual
Prefix:
First Name:KATHRYN
Middle Name:E
Last Name:SPIGHT
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:KATHRYN
Other - Middle Name:E
Other - Last Name:BEVIS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA-C
Mailing Address - Street 1:660 GOLDEN RIDGE RD
Mailing Address - Street 2:STE. 250
Mailing Address - City:GOLDEN
Mailing Address - State:CO
Mailing Address - Zip Code:80401-9541
Mailing Address - Country:US
Mailing Address - Phone:303-233-1223
Mailing Address - Fax:303-233-8755
Practice Address - Street 1:660 GOLDEN RIDGE RD
Practice Address - Street 2:STE. 250
Practice Address - City:GOLDEN
Practice Address - State:CO
Practice Address - Zip Code:80401-9541
Practice Address - Country:US
Practice Address - Phone:303-233-1223
Practice Address - Fax:303-233-8755
Is Sole Proprietor?:No
Enumeration Date:2011-12-22
Last Update Date:2016-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO3334363A00000X, 363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO99106876Medicaid
CO99106876Medicaid