Provider Demographics
NPI:1881875581
Name:ISACKS, KATHERINE ANN (MPS, RD)
Entity type:Individual
Prefix:
First Name:KATHERINE
Middle Name:ANN
Last Name:ISACKS
Suffix:
Gender:F
Credentials:MPS, RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3555 LUTHERAN PKWY
Mailing Address - Street 2:SUITE 180
Mailing Address - City:WHEAT RIDGE
Mailing Address - State:CO
Mailing Address - Zip Code:80033-6021
Mailing Address - Country:US
Mailing Address - Phone:303-403-3604
Mailing Address - Fax:303-425-2792
Practice Address - Street 1:3555 LUTHERAN PKWY
Practice Address - Street 2:SUITE 180
Practice Address - City:WHEAT RIDGE
Practice Address - State:CO
Practice Address - Zip Code:80033-6021
Practice Address - Country:US
Practice Address - Phone:303-403-3604
Practice Address - Fax:303-425-2792
Is Sole Proprietor?:No
Enumeration Date:2007-11-21
Last Update Date:2007-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered