Provider Demographics
NPI:1336441021
Name:ODENWALD, KATE C (RN, ACNP-BC)
Entity Type:Individual
Prefix:
First Name:KATE
Middle Name:C
Last Name:ODENWALD
Suffix:
Gender:F
Credentials:RN, ACNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:3712 BROMLEY DR
Mailing Address - Street 2:
Mailing Address - City:FORT COLLINS
Mailing Address - State:CO
Mailing Address - Zip Code:80525-9001
Mailing Address - Country:US
Mailing Address - Phone:970-481-2390
Mailing Address - Fax:970-617-1925
Practice Address - Street 1:3920 S SHIELDS ST
Practice Address - Street 2:
Practice Address - City:FORT COLLINS
Practice Address - State:CO
Practice Address - Zip Code:80526-3015
Practice Address - Country:US
Practice Address - Phone:970-481-2390
Practice Address - Fax:970-617-1925
Is Sole Proprietor?:No
Enumeration Date:2010-12-01
Last Update Date:2022-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COAPN.0994210-NP363LA2100X
TX730799363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care