Healthcare Provider Details

I. General information

NPI: 1457913592
Provider Name (Legal Business Name): KATRINA MIERKEY CPNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: KATRINA MIERKEY KATRINA SCHMITT

II. Dates (important events)

Enumeration Date: 06/28/2019
Last Update Date: 09/01/2022
Certification Date: 09/01/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

96 WADSWORTH BLVD UNIT 100
LAKEWOOD CO
80226-1516
US

IV. Provider business mailing address

96 WADSWORTH BLVD UNIT 100
LAKEWOOD CO
80226-1516
US

V. Phone/Fax

Practice location:
  • Phone: 303-239-8327
  • Fax: 303-239-9946
Mailing address:
  • Phone: 303-239-8327
  • Fax: 303-239-9946

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP2300X
TaxonomyPrimary Care Nurse Practitioner
License NumberC-APN.0001568-C-NP
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: