Healthcare Provider Details

I. General information

NPI: 1477639979
Provider Name (Legal Business Name): KATHERINE LOUISE DRAPEAU DO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/27/2006
Last Update Date: 08/08/2023
Certification Date: 08/08/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

562 GREGORY ST.
BLACK HAWK CO
80422-0066
US

IV. Provider business mailing address

PO BOX 9 20 E. LAKEVIEW DR. SUITE 109
NEDERLAND CO
80466-0009
US

V. Phone/Fax

Practice location:
  • Phone: 970-945-2840
  • Fax: 303-582-1003
Mailing address:
  • Phone: 970-945-2840
  • Fax: 303-258-7140

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number27765
License Number StateCO
# 2
Primary TaxonomyY
Taxonomy Code2083X0100X
TaxonomyOccupational Medicine Physician
License NumberDR.0027765
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: