Healthcare Provider Details

I. General information

NPI: 1316528706
Provider Name (Legal Business Name): KAITLIN ALEXANDRA WOMELDORF PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/16/2021
Last Update Date: 02/06/2026
Certification Date: 02/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11605 MERIDIAN MARKET VW STE 184
FALCON CO
80831-8238
US

IV. Provider business mailing address

2695 ROCKY MOUNTAIN AVE STE 150
LOVELAND CO
80538-9071
US

V. Phone/Fax

Practice location:
  • Phone: 719-364-9560
  • Fax: 719-364-7680
Mailing address:
  • Phone: 970-624-4333
  • Fax: 970-490-4173

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberPA.0007428
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: