Individual
KATHERINE FIFER WILFLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C, MMSC
Contact information
Practice address
777 BANNOCK ST, DENVER, CO 80204-4507
(303) 436-6000
Mailing address
777 BANNOCK ST, DENVER, CO 80204-4507
(303) 436-6000
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
CO3282
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00936660
MEDICARE RAILROAD
OR
01
—
383860
MEDICARE RHC
OR
05
—
500605562
—
OR
Enumeration date
03/31/2008
Last updated
04/01/2021
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