Healthcare Provider Details

I. General information

NPI: 1104574193
Provider Name (Legal Business Name): KATE MARGARET FATH PA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: KATE TUMULTY

II. Dates (important events)

Enumeration Date: 03/17/2022
Last Update Date: 04/09/2026
Certification Date: 04/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2801 PURCELL ST
BRIGHTON CO
80601-3551
US

IV. Provider business mailing address

2573 WISTERIA DR
ERIE CO
80516-7935
US

V. Phone/Fax

Practice location:
  • Phone: 303-659-9700
  • Fax: 720-336-3989
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberPA.0007215
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: