Basic Information
| Provider Information | |||||||||
| NPI: | 1538309687 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | AUSTIN | ||||||||
| FirstName: | KATJA | ||||||||
| MiddleName: | S. | ||||||||
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| Credential: | FNP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 455 N SHERMAN ST | ||||||||
| Address2: | SUITE #510 | ||||||||
| City: | DENVER | ||||||||
| State: | CO | ||||||||
| PostalCode: | 802034400 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3033368317 | ||||||||
| FaxNumber: | 3033368350 | ||||||||
| Practice Location | |||||||||
| Address1: | 455 N SHERMAN ST | ||||||||
| Address2: | SUITE #510 | ||||||||
| City: | DENVER | ||||||||
| State: | CO | ||||||||
| PostalCode: | 802034400 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3033368317 | ||||||||
| FaxNumber: | 3033368350 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/03/2009 | ||||||||
| LastUpdateDate: | 09/13/2016 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 163W00000X | 181628 | CO | N | Nursing Service Providers | Registered Nurse | 363LF0000X | NP-990129 | CO | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Family |
ID Information
| ID | Type | State | Issuer | Description | 84180811 | 05 | CO | MEDICAID |