Healthcare Provider Details

I. General information

NPI: 1932637782
Provider Name (Legal Business Name): KATTIE CHRISTINE TRUESDELL CRNA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/24/2017
Last Update Date: 12/19/2024
Certification Date: 12/19/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2555 E 13TH ST STE 210
LOVELAND CO
80537-5136
US

IV. Provider business mailing address

3702 S TIMBERLINE RD STE A
FORT COLLINS CO
80525-3625
US

V. Phone/Fax

Practice location:
  • Phone: 970-669-5432
  • Fax:
Mailing address:
  • Phone: 970-207-9773
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number116411
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: