Healthcare Provider Details

I. General information

NPI: 1205838901
Provider Name (Legal Business Name): KATHLEEN S. KNOTTS CNS, RXN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/11/2005
Last Update Date: 03/07/2023
Certification Date: 12/16/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14301 E HAMPDEN AVE
AURORA CO
80014-3902
US

IV. Provider business mailing address

1290 CHAMBERS RD
AURORA CO
80011-7117
US

V. Phone/Fax

Practice location:
  • Phone: 303-617-2300
  • Fax:
Mailing address:
  • Phone: 303-617-2300
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberAPN.0001452.CNS
License Number StateCO
# 2
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberAPN.0001452-CNS
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: