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General NPI Number Information
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NPI Number | 1841729399
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Entity Type | Organization
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Legal Business Name | KATIE COLVARD N.P., LLC
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Dates
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Enumeration Date | 06/08/2017
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 320 MONTEBELLO OAKS DR
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City | PASO ROBLES
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State | CA
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Zip | 93446-7116
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Country | US
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Telephone | 805-835-8865
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Fax |
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Provider Business Mailing Address
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Address Line | 320 MONTEBELLO OAKS DR
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City | PASO ROBLES
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State | CA
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Zip | 93446-7116
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Country | US
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Telephone | 805-835-8865
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MRS. KATIE ANNE COLVARD
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Credential | NP
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Telephone | 805-835-8865
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 95006711
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License Number State | CA
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