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General NPI Number Information
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NPI Number | 1346418225
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Entity Type | Individual
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Provider Name | KATIE ROSE ELLERBROCK M.D
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Gender | Female
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Dates
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Enumeration Date | 02/13/2008
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Last Update Date | 02/13/2008
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Provider Practice Location Address
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Address Line | 1719 E 19TH AVE 5C EAST
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City | DENVER
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State | CO
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Zip | 80218-1235
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Country | US
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Telephone | 303-839-6741
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Fax |
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Provider Business Mailing Address
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Address Line | 336 GRANT ST APT 301
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City | DENVER
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State | CO
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Zip | 80203-4066
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Country | US
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Telephone | 216-287-8892
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 282N00000X
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Taxonomy Name | General Acute Care Hospital
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License Number | 2580
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License Number State | CO
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