Healthcare Provider Details

I. General information

NPI: 1578429825
Provider Name (Legal Business Name): KARA DAWN WHITEDOVE
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: BROOKE WHITEDOVE

II. Dates (important events)

Enumeration Date: 12/30/2025
Last Update Date: 12/30/2025
Certification Date: 12/30/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16218 JACKSON CREEK PKWY
MONUMENT CO
80132-7181
US

IV. Provider business mailing address

8370 W US HIGHWAY 24 APT 9
CASCADE CO
80809-1223
US

V. Phone/Fax

Practice location:
  • Phone: 719-484-0930
  • Fax: 719-484-0932
Mailing address:
  • Phone: 719-452-0179
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code156FX1800X
TaxonomyOptician
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: