Doctor Name: | KATHERINE DENISE KOLLER |
NPI Number: | 1003973785 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | APRN |
License Number: | 192852-4405 |
Business Practice Address: | 315 S 100 E Provo, UT - 846064649 |
Business Phone Number: | 8018518517 |
Business Fax Number: | |
Mailing Address: | 315 S 100 E, PROVO |
State: | UT |
Postal Code: | 846064649 |
Phone Number: | 8018518517 |
Fax Number: | |
NPI Enumeration Date: | 01/02/2007 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 163WP0807X |
License Number: | 192852-4405 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | UT |
Taxonomy Type: | Nursing Service Providers |
Taxonomy Classification: | Registered Nurse |
Taxonomy Specialization: | Psych/Mental Health, Child & Adolescent |
Taxonomy Definition: |