| Doctor Name: | MS. KATHLEEN ANN MOULDS |
| NPI Number: | 1457479370 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | FNP |
| License Number: | 78274 |
| Business Practice Address: | 100 W 4th St Walsenburg, CO - 810891910 |
| Business Phone Number: | 7197381164 |
| Business Fax Number: | 7197383399 |
| Mailing Address: | Po Box 52, GARDNER |
| State: | CO |
| Postal Code: | 810400052 |
| Phone Number: | 7197462069 |
| Fax Number: | 7197383399 |
| NPI Enumeration Date: | 03/27/2007 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LF0000X |
| License Number: | 78274 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | CO |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Family |
| Taxonomy Definition: | |