Healthcare Provider Details

I. General information

NPI: 1902123557
Provider Name (Legal Business Name): KATHLEEN ANGELA KOHLS MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/22/2010
Last Update Date: 10/08/2026
Certification Date: 10/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10099 RIDGEGATE PKWY
LONE TREE CO
80124-5531
US

IV. Provider business mailing address

10264 SWEET ROCK CT
PARKER CO
80134-9160
US

V. Phone/Fax

Practice location:
  • Phone: 303-791-2112
  • Fax:
Mailing address:
  • Phone: 719-237-9138
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License NumberDR.0067484
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: