Healthcare Provider Details

I. General information

NPI: 1942337928
Provider Name (Legal Business Name): CATHERINE R TACINAS RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/27/2007
Last Update Date: 07/11/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1375 EAST 20TH AVE SKYLINE 4TH FLOOR
DENVER CO
80205-1618
US

IV. Provider business mailing address

1375 E 20TH AVE 4TH FLOOR IM
DENVER CO
80205-5423
US

V. Phone/Fax

Practice location:
  • Phone: 303-861-3490
  • Fax:
Mailing address:
  • Phone: 303-861-3490
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WI0600X
TaxonomyInfection Control Registered Nurse
License Number69843
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: