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General NPI Number Information
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NPI Number | 1932240520
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Entity Type | Individual
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Provider Name | CYNTHIA RENEE BROMLEY-KATOR PAC
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Gender | Female
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Dates
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Enumeration Date | 02/08/2007
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Last Update Date | 12/02/2013
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Provider Practice Location Address
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Address Line | 2960 N CIRCLE DR SUITE 100
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City | COLORADO SPRINGS
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State | CO
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Zip | 80909-1163
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Country | US
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Telephone | 719-776-4646
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Fax | 719-776-4640
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Provider Business Mailing Address
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Address Line | 2960 N CIRCLE DR SUITE 100
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City | COLORADO SPRINGS
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State | CO
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Zip | 80909-1163
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Country | US
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Telephone | 719-776-4646
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Fax | 719-776-4640
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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 | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | PA17450
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 723
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License Number State | CO
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Taxonomy #3
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 011002658
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License Number State | VA
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