MEDICARE: KATHRYN A LEIN PNP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LP0200X	Pediatric Nurse Practitioner	200550172NP	OR
2	363LP0200X	Pediatric Nurse Practitioner	R39460	ND
3	363LP0200X	Pediatric Nurse Practitioner	C-APN.0004362-C-NP	CO

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1487743332
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KATHRYN A LEIN PNP

Provider Business Mailing Address
First Line	:	PO BOX 7328
Second Line	:
City	:	LOVELAND
State	:	CO
Zip	:	80537-0328
Country	:	US
Telephone Number	:	970-663-2742
Fax Number	:	970-667-0847

Provider Business Practice Location Address
First Line	:	4845 WEITZEL ST STE 101
Second Line	:
City	:	TIMNATH
State	:	CO
Zip	:	80547-4800
Country	:	US
Telephone Number	:	970-267-9510
Fax Number	:	970-207-9967

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/11/2006
Last Update Date	:	08/29/2022

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Directions to “ KATHRYN A LEIN PNP” Practice Location

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