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NPI Code Detail

MEDICARE: RUTH KATHERINE HOLLENBACK BS

MEDICARE: RUTH KATHERINE HOLLENBACK BS
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
1174H00000XHealth Educator

General Provider Information

NPI Number : 1356931596
Entity Type Code : Individual
Provider Name (Legal Business Name) : RUTH KATHERINE HOLLENBACK BS
Provider Business Mailing Address
First Line : 1590 WYNKOOP ST APT 624
Second Line :
City : DENVER
State : CO
Zip : 80202-1172
Country : US
Telephone Number : 303-601-9562
Fax Number :
Provider Business Practice Location Address
First Line : 1648 GAYLORD ST
Second Line :
City : DENVER
State : CO
Zip : 80206-1239
Country : US
Telephone Number : 303-336-1631
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/21/2021
Last Update Date : 01/21/2021

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Directions to “ RUTH KATHERINE HOLLENBACK BS” Practice Location

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