Healthcare Provider Details

I. General information

NPI: 1467531491
Provider Name (Legal Business Name): KATE DYKEMA CNM
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/02/2006
Last Update Date: 07/06/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

601 E HAMPDEN AVE #540
ENGLEWOOD CO
80113-3781
US

IV. Provider business mailing address

7100 E BELLEVIEW AVE STE. 109
GREENWOOD VILLAGE CO
80111
US

V. Phone/Fax

Practice location:
  • Phone: 303-788-6297
  • Fax: 303-788-7658
Mailing address:
  • Phone: 303-694-3900
  • Fax: 303-721-8853

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code176B00000X
TaxonomyMidwife
License NumberRN 71987
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: