MEDICARE: KATHERINE GOLDEN RN

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	171M00000X	Case Manager/Care Coordinator	0173425	CO
2	163WC0400X	Case Management Registered Nurse	0173425	CO

General Provider Information

NPI Number	:	1972365013
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KATHERINE GOLDEN RN

Provider Business Mailing Address
First Line	:	3148 W 62ND AVE
Second Line	:
City	:	DENVER
State	:	CO
Zip	:	80221-1907
Country	:	US
Telephone Number	:	720-308-0931
Fax Number	:

Provider Business Practice Location Address
First Line	:	3148 W 62ND AVE
Second Line	:
City	:	DENVER
State	:	CO
Zip	:	80221-1907
Country	:	US
Telephone Number	:	720-308-0931
Fax Number	:

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

Provider Enumeration Date	:	01/24/2024
Last Update Date	:	01/24/2024

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