Individual
KATHERINE MARIE GLASS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
35 LINDBERGH DR UNIT 110, GYPSUM, CO 81637-5461
(970) 431-2871
Mailing address
626 LARIAT LOOP, NEW CASTLE, CO 81647-9476
(919) 656-3654
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
0994749
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0994749
COLORADO APN LICENSE
CO
Enumeration date
07/11/2019
Last updated
10/20/2023
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