Provider Demographics
NPI:1528345782
Name:KISSLER, KATHERINE J (CNM, RN, PHD)
Entity type:Individual
Prefix:DR
First Name:KATHERINE
Middle Name:J
Last Name:KISSLER
Suffix:
Gender:F
Credentials:CNM, RN, PHD
Other - Prefix:
Other - First Name:KATHERINE
Other - Middle Name:JEAN
Other - Last Name:BONES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 110429
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80042-0429
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1635 AURORA COURT
Practice Address - Street 2:AOP 3425
Practice Address - City:AUORA
Practice Address - State:CO
Practice Address - Zip Code:80045
Practice Address - Country:US
Practice Address - Phone:708-481-1738
Practice Address - Fax:720-848-1844
Is Sole Proprietor?:No
Enumeration Date:2011-11-15
Last Update Date:2022-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CORN.1635284163W00000X
COAPN.0991952-CNM367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife
No163W00000XNursing Service ProvidersRegistered Nurse