Healthcare Provider Details
I. General information
NPI: 1790812741
Provider Name (Legal Business Name): KAREN A KOCHANSKI PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 02/27/2007
Last Update Date: 01/29/2015
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
11245 HURON ST
WESTMINSTER CO
80234-2806
US
IV. Provider business mailing address
11245 HURON ST
WESTMINSTER CO
80234-2806
US
V. Phone/Fax
- Phone: 303-338-4545
- Fax:
- Phone: 303-338-4545
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 363A00000X |
| Taxonomy | Physician Assistant |
| License Number | 970 |
| License Number State | CO |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: