Provider Demographics
NPI:1730812314
Name:ROY, KATRINA MARITA (MSN, APRN, AGACNP-BC)
Entity type:Individual
Prefix:
First Name:KATRINA
Middle Name:MARITA
Last Name:ROY
Suffix:
Gender:F
Credentials:MSN, APRN, AGACNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6058 BRAVE EAGLE DR
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80924-2063
Mailing Address - Country:US
Mailing Address - Phone:719-322-1947
Mailing Address - Fax:
Practice Address - Street 1:3027 N CIRCLE DR
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80909-1179
Practice Address - Country:US
Practice Address - Phone:719-776-3600
Practice Address - Fax:719-776-3610
Is Sole Proprietor?:No
Enumeration Date:2022-07-01
Last Update Date:2022-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CORN.0197507163W00000X
COAPN.0997249-NP363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care
No163W00000XNursing Service ProvidersRegistered Nurse