MEDICARE: KATHLEEN R MAGUIRE PA-C

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	363AM0700X	Medical Physician Assistant	830	CO

General Provider Information

NPI Number	:	1710005475
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KATHLEEN R MAGUIRE PA-C

Provider Business Mailing Address
First Line	:	2627 REDWING RD STE 300
Second Line	:
City	:	FORT COLLINS
State	:	CO
Zip	:	80526-6310
Country	:	US
Telephone Number	:	970-631-8650
Fax Number	:	970-672-8137

Provider Business Practice Location Address
First Line	:	2627 REDWING RD STE 300
Second Line	:
City	:	FORT COLLINS
State	:	CO
Zip	:	80526-6310
Country	:	US
Telephone Number	:	970-631-8650
Fax Number	:

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

Provider Enumeration Date	:	03/27/2007
Last Update Date	:	03/14/2024

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Directions to “ KATHLEEN R MAGUIRE PA-C” Practice Location

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