MEDICARE: MRS. PAULA MARIE CATLIN RN

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	163W00000X	Registered Nurse	1636196	CO
2	225700000X	Massage Therapist	1681	CO

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	1700123379	OTHER	CO	KAISER

General Provider Information

NPI Number	:	1700123379
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. PAULA MARIE CATLIN RN

Provider Business Mailing Address
First Line	:	12349 ONEIDA STREET
Second Line	:
City	:	THORNTON
State	:	CO
Zip	:	80602
Country	:	US
Telephone Number	:	720-299-7447
Fax Number	:

Provider Business Practice Location Address
First Line	:	2751 W 120TH AVE
Second Line	:	SUITE 200
City	:	WESTMINSTER
State	:	CO
Zip	:	80234-2986
Country	:	US
Telephone Number	:	720-299-7447
Fax Number	:

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

Provider Enumeration Date	:	01/15/2013
Last Update Date	:	05/04/2018

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