Healthcare Provider Details

I. General information

NPI: 1992587695
Provider Name (Legal Business Name): KATHERINE HILBURN RN, BSN, IBCLC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/17/2023
Last Update Date: 10/17/2023
Certification Date: 10/17/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4900 E KENTUCKY AVE
DENVER CO
80246-2365
US

IV. Provider business mailing address

4900 E KENTUCKY AVE
DENVER CO
80246-2365
US

V. Phone/Fax

Practice location:
  • Phone: 720-252-7171
  • Fax:
Mailing address:
  • Phone: 720-252-7171
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WL0100X
TaxonomyLactation Consultant (Registered Nurse)
License NumberL-311638
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: