Provider Demographics
NPI:1245502483
Name:LOSCHEIDER, KATIE JO (PA - C)
Entity type:Individual
Prefix:MRS
First Name:KATIE
Middle Name:JO
Last Name:LOSCHEIDER
Suffix:
Gender:F
Credentials:PA - C
Other - Prefix:
Other - First Name:KATIE
Other - Middle Name:JO
Other - Last Name:PERPICH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA-C
Mailing Address - Street 1:2695 ROCKY MOUNTAIN AVE STE 150
Mailing Address - Street 2:
Mailing Address - City:LOVELAND
Mailing Address - State:CO
Mailing Address - Zip Code:80538-9071
Mailing Address - Country:US
Mailing Address - Phone:970-624-4034
Mailing Address - Fax:970-490-4347
Practice Address - Street 1:1035 GARDEN OF THE GODS RD STE 120
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80907
Practice Address - Country:US
Practice Address - Phone:719-365-3200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-02-03
Last Update Date:2021-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN10941363A00000X
AZ5217363A00000X
NC0010-06359363A00000X
COMSPA.0000004363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant