Provider Demographics
NPI:1104116938
Name:FRASCA, KATHERINE LYNN (MD)
Entity type:Individual
Prefix:
First Name:KATHERINE
Middle Name:LYNN
Last Name:FRASCA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1635 AURORA CT
Mailing Address - Street 2:MAIL STOP B-163, PO BOX 6510
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80045-2541
Mailing Address - Country:US
Mailing Address - Phone:720-848-0191
Mailing Address - Fax:
Practice Address - Street 1:1635 AURORA CT
Practice Address - Street 2:MAIL STOP B-163, INFECTIOUS DISEASE GROUP PRACTICE
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80045-2541
Practice Address - Country:US
Practice Address - Phone:720-848-0191
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-04-13
Last Update Date:2016-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMT198832207R00000X, 390200000X
CODR.0056417207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program