Provider Demographics
NPI:1598011330
Name:TWOMEY, KATHLEEN ANNE (BS)
Entity type:Individual
Prefix:
First Name:KATHLEEN
Middle Name:ANNE
Last Name:TWOMEY
Suffix:
Gender:F
Credentials:BS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5240 N ACADEMY BLVD
Mailing Address - Street 2:T-154
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80918-4004
Mailing Address - Country:US
Mailing Address - Phone:719-262-6638
Mailing Address - Fax:
Practice Address - Street 1:5240 N ACADEMY BLVD
Practice Address - Street 2:T-154
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80918-4004
Practice Address - Country:US
Practice Address - Phone:719-262-6638
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-07-30
Last Update Date:2012-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO12388183500000X
WY2455183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist