Provider Demographics
NPI:1316528706
Name:WOMELDORF, KAITLIN ALEXANDRA (PA-C)
Entity type:Individual
Prefix:
First Name:KAITLIN
Middle Name:ALEXANDRA
Last Name:WOMELDORF
Suffix:
Gender:F
Credentials:PA-C
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Mailing Address - Street 1:4205 SWANSON WAY UNIT 204
Mailing Address - Street 2:
Mailing Address - City:CASTLE ROCK
Mailing Address - State:CO
Mailing Address - Zip Code:80109-6320
Mailing Address - Country:US
Mailing Address - Phone:720-371-2243
Mailing Address - Fax:
Practice Address - Street 1:1400 E BOULDER ST
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80909-5533
Practice Address - Country:US
Practice Address - Phone:719-205-4514
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-04-16
Last Update Date:2023-01-30
Deactivation Date:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant