Individual
KATHLEEN M CALLANAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
580 MOHAWK DR, BOULDER, CO 80303-3712
(303) 239-7294
Mailing address
504 HAPGOOD ST, BOULDER, CO 80302-6966
(303) 449-7298
Taxonomy
Speciality
Code
Description
License number
State
363LX0001X
Obstetrics & Gynecology Nurse Practitioner
Primary
48406
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
005669
KAISER-COMMERCIAL NUMBER
—
05
—
89733711
—
CO
Enumeration date
02/16/2007
Last updated
03/05/2008
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