MEDICARE: KATE SAWICKI

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208000000X	Pediatrics Physician	A-2507-21	NM
2	390200000X	Student in an Organized Health Care Education/Training Program		NM
3	208000000X	Pediatrics Physician	DR.0071297	CO

General Provider Information

NPI Number	:	1114422946
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KATE SAWICKI

Provider Business Mailing Address
First Line	:	360 W PARK DR STE 201
Second Line	:
City	:	GRAND JUNCTION
State	:	CO
Zip	:	81505-1619
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	360 W PARK DR STE 201
Second Line	:
City	:	GRAND JUNCTION
State	:	CO
Zip	:	81505-1619
Country	:	US
Telephone Number	:	970-609-7337
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/25/2018
Last Update Date	:	07/19/2023

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Directions to “ KATE SAWICKI ” Practice Location

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