Provider Demographics
NPI:1215935515
Name:HEBENSTREIT, KATHRYN P (MD)
Entity type:Individual
Prefix:
First Name:KATHRYN
Middle Name:P
Last Name:HEBENSTREIT
Suffix:
Gender:F
Credentials:MD
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Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:3455 LUTHERAN PKWY
Mailing Address - Street 2:260
Mailing Address - City:WHEAT RIDGE
Mailing Address - State:CO
Mailing Address - Zip Code:80033-6024
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3455 LUTHERAN PKWY
Practice Address - Street 2:260
Practice Address - City:WHEAT RIDGE
Practice Address - State:CO
Practice Address - Zip Code:80033-6024
Practice Address - Country:US
Practice Address - Phone:303-940-1867
Practice Address - Fax:303-940-1894
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-07-11
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CO29819207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO01298199Medicaid
COH29234Medicare UPIN