Provider Demographics
NPI:1255825089
Name:CALDERWOOD, KATHRYN (PA-C)
Entity type:Individual
Prefix:
First Name:KATHRYN
Middle Name:
Last Name:CALDERWOOD
Suffix:
Gender:
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:500 W 144TH AVE STE 130
Mailing Address - Street 2:
Mailing Address - City:WESTMINSTER
Mailing Address - State:CO
Mailing Address - Zip Code:80023-9326
Mailing Address - Country:US
Mailing Address - Phone:303-649-3800
Mailing Address - Fax:303-649-3819
Practice Address - Street 1:500 W 144TH AVE STE 130
Practice Address - Street 2:
Practice Address - City:WESTMINSTER
Practice Address - State:CO
Practice Address - Zip Code:80023-9326
Practice Address - Country:US
Practice Address - Phone:303-649-3800
Practice Address - Fax:303-649-3819
Is Sole Proprietor?:No
Enumeration Date:2018-06-15
Last Update Date:2025-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COPA0005435363A00000X
COPA.0005435363AS0400X
363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical