Basic Information
| Provider Information | |||||||||
| NPI: | 1164735742 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | REGGIO | ||||||||
| FirstName: | KATHRYN | ||||||||
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| Credential: | WHNP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 559 VINCENT ST | ||||||||
| Address2: | |||||||||
| City: | PETERSON AFB | ||||||||
| State: | CO | ||||||||
| PostalCode: | 809141541 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7195560510 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 559 VINCENT ST | ||||||||
| Address2: | |||||||||
| City: | PETERSON AFB | ||||||||
| State: | CO | ||||||||
| PostalCode: | 809141541 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7195560510 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/23/2010 | ||||||||
| LastUpdateDate: | 09/30/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 09/30/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 163W00000X | RN00158509 | WA | N | Nursing Service Providers | Registered Nurse | 363LX0001X | AP60187115 | WA | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Obstetrics & Gynecology |
No ID Information.