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NPI 1780926428

NPI 1780926428 : KATELYN HELEN DEGNER CPO : LAS VEGAS, NV

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General NPI Number Information
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    NPI Number           |    1780926428
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    Entity Type          |    Individual 
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    Provider Name        |    KATELYN HELEN DEGNER CPO
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    03/20/2013
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    Last Update Date     |    09/19/2024
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Provider Practice Location Address
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    Address Line         |    810 S DURANGO DR STE 100 
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    City                 |    LAS VEGAS
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    State                |    NV
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    Zip                  |    89145-2487
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    Country              |    US
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    Telephone            |    702-932-1300
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    4945 ALONDRA DR 
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    City                 |    LAS VEGAS
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    State                |    NV
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    Zip                  |    89118-1128
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    Country              |    US
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    Telephone            |    971-732-6231
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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        |    222Z00000X
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    Taxonomy Name        |    Orthotist
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    License Number       |    
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    License Number State |    
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Taxonomy #2
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    Taxonomy Code        |    224P00000X
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    Taxonomy Name        |    Prosthetist
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    License Number       |    
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    License Number State |    
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