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General NPI Number Information
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NPI Number | 1396654299
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Entity Type | Individual
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Provider Name | KATELYN YADAO
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Gender | Female
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Dates
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Enumeration Date | 09/04/2026
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Last Update Date | 09/04/2026
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Provider Practice Location Address
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Address Line | 6255 SAWCUT PT
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City | FOUNTAIN
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State | CO
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Zip | 80817-1867
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Country | US
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Telephone | 719-359-9080
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Fax |
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Provider Business Mailing Address
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Address Line | 6675 MANDAN DR
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City | COLORADO SPRINGS
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State | CO
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Zip | 80925-8454
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Country | US
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Telephone |
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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 | 183500000X
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Taxonomy Name | Pharmacist
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License Number | PHA.0025727
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License Number State | CO
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