Healthcare Provider Details

I. General information

NPI: 1184622888
Provider Name (Legal Business Name): KATHERINE LYNN WALKER M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/07/2005
Last Update Date: 07/22/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6800 79TH ST SUITE 102
NIWOT CO
80503-0000
US

IV. Provider business mailing address

1707 COLE BLVD STE 250
GOLDEN CO
80401-3220
US

V. Phone/Fax

Practice location:
  • Phone: 720-494-7100
  • Fax: 303-652-0518
Mailing address:
  • Phone: 303-763-4900
  • Fax: 303-763-5495

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number40593
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: