Provider Demographics
NPI:1831451152
Name:CHURCHILL, KATHERINE L (MSN, APRN, PMHNP-BC)
Entity type:Individual
Prefix:
First Name:KATHERINE
Middle Name:L
Last Name:CHURCHILL
Suffix:
Gender:F
Credentials:MSN, APRN, PMHNP-BC
Other - Prefix:
Other - First Name:KATHERINE
Other - Middle Name:LINDSAY
Other - Last Name:VAN NOY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MSN, APRN, PMHNP-BC
Mailing Address - Street 1:825 E SPEER BLVD STE 8
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80218-3719
Mailing Address - Country:US
Mailing Address - Phone:844-336-5597
Mailing Address - Fax:
Practice Address - Street 1:5424 W HIGHWAY 290 STE 108
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78735-8827
Practice Address - Country:US
Practice Address - Phone:512-430-1130
Practice Address - Fax:512-677-6806
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-12
Last Update Date:2021-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX791448163WP0808X
COC-APN.0002099-C-NP363LP0808X
TXAP121966363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental Health