Provider Demographics
NPI:1154190932
Name:STEPHENS, KATHERINE CHRISTINE (MD ABFM MBCHB DRCOG)
Entity type:Individual
Prefix:DR
First Name:KATHERINE
Middle Name:CHRISTINE
Last Name:STEPHENS
Suffix:
Gender:F
Credentials:MD ABFM MBCHB DRCOG
Other - Prefix:DR
Other - First Name:KATHERINE
Other - Middle Name:STEPHENS
Other - Last Name:MCKIE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD ABFM MBCHB DRCOG
Mailing Address - Street 1:18746 64.95 ROAD
Mailing Address - Street 2:
Mailing Address - City:MONTROSE
Mailing Address - State:CO
Mailing Address - Zip Code:81403
Mailing Address - Country:US
Mailing Address - Phone:970-275-5227
Mailing Address - Fax:
Practice Address - Street 1:816 S 5TH ST
Practice Address - Street 2:
Practice Address - City:MONTROSE
Practice Address - State:CO
Practice Address - Zip Code:81401-5765
Practice Address - Country:US
Practice Address - Phone:970-249-7751
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-12-21
Last Update Date:2024-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CODR.0072238207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine