Provider Demographics
NPI:1104597335
Name:CORNAKOVA, KATARINA (PHARMD)
Entity type:Individual
Prefix:DR
First Name:KATARINA
Middle Name:
Last Name:CORNAKOVA
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2615 W 25TH AVE APT 2
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80211-4864
Mailing Address - Country:US
Mailing Address - Phone:720-421-9894
Mailing Address - Fax:
Practice Address - Street 1:3251 REVERE ST STE 205
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80011-1847
Practice Address - Country:US
Practice Address - Phone:877-368-0304
Practice Address - Fax:866-645-6337
Is Sole Proprietor?:Yes
Enumeration Date:2021-09-27
Last Update Date:2021-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO0023763183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist