Provider Demographics
NPI:1124353701
Name:PALOMINO, KATHERINE REAM (CRNA)
Entity type:Individual
Prefix:MRS
First Name:KATHERINE
Middle Name:REAM
Last Name:PALOMINO
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:MISS
Other - First Name:KATHERINE
Other - Middle Name:ELAINE
Other - Last Name:REAM
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CRNA
Mailing Address - Street 1:3333 S. WADSWORTH BLVD
Mailing Address - Street 2:#D-100
Mailing Address - City:LAKEWOOD
Mailing Address - State:CO
Mailing Address - Zip Code:80227
Mailing Address - Country:US
Mailing Address - Phone:303-205-1090
Mailing Address - Fax:303-531-4156
Practice Address - Street 1:3333 S. WADSWORTH BLVD
Practice Address - Street 2:#D-100
Practice Address - City:LAKEWOOD
Practice Address - State:CO
Practice Address - Zip Code:80227
Practice Address - Country:US
Practice Address - Phone:303-205-1090
Practice Address - Fax:303-531-4156
Is Sole Proprietor?:Yes
Enumeration Date:2009-10-15
Last Update Date:2013-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY6196367500000X
CO0990681367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered