Provider Demographics
NPI:1760471213
Name:TERUEL, KATHERINE STRIFE (MD)
Entity type:Individual
Prefix:
First Name:KATHERINE
Middle Name:STRIFE
Last Name:TERUEL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:KATHERINE
Other - Middle Name:S
Other - Last Name:TERUEL
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:1627 E 18TH ST
Mailing Address - Street 2:
Mailing Address - City:LOVELAND
Mailing Address - State:CO
Mailing Address - Zip Code:80538-4209
Mailing Address - Country:US
Mailing Address - Phone:970-663-0135
Mailing Address - Fax:970-461-1422
Practice Address - Street 1:2555 E 13TH ST
Practice Address - Street 2:STE 130
Practice Address - City:LOVELAND
Practice Address - State:CO
Practice Address - Zip Code:80537-5113
Practice Address - Country:US
Practice Address - Phone:970-663-5437
Practice Address - Fax:970-669-5762
Is Sole Proprietor?:No
Enumeration Date:2005-10-18
Last Update Date:2010-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT0420010572208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
VT1010515Medicaid
CO79170871Medicaid
CO79170871Medicaid
VT1010515Medicaid