Provider Demographics
NPI:1801109475
Name:KOWALSKI, CAITLIN ROSE (RN)
Entity type:Individual
Prefix:
First Name:CAITLIN
Middle Name:ROSE
Last Name:KOWALSKI
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11095 W TEXAS AVE
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD
Mailing Address - State:CO
Mailing Address - Zip Code:80232-4951
Mailing Address - Country:US
Mailing Address - Phone:303-350-0421
Mailing Address - Fax:
Practice Address - Street 1:2530 S PARKER RD
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80014-1623
Practice Address - Country:US
Practice Address - Phone:303-614-1500
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-07-23
Last Update Date:2010-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO196062163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse