Provider Demographics
NPI:1487619367
Name:OKAMATSU, KATHY (NP)
Entity type:Individual
Prefix:
First Name:KATHY
Middle Name:
Last Name:OKAMATSU
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:500 ELDORADO BLVD
Mailing Address - Street 2:SUITE 6250
Mailing Address - City:BROOMFIELD
Mailing Address - State:CO
Mailing Address - Zip Code:80021-3408
Mailing Address - Country:US
Mailing Address - Phone:303-272-0750
Mailing Address - Fax:
Practice Address - Street 1:500 ELDORADO BLVD
Practice Address - Street 2:SUITE 6250
Practice Address - City:BROOMFIELD
Practice Address - State:CO
Practice Address - Zip Code:80021-3408
Practice Address - Country:US
Practice Address - Phone:303-272-0750
Practice Address - Fax:303-318-2488
Is Sole Proprietor?:No
Enumeration Date:2006-04-20
Last Update Date:2014-05-14
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CO96725363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner