Provider Demographics
NPI:1487743332
Name:LEIN, KATHRYN A (PNP)
Entity type:Individual
Prefix:
First Name:KATHRYN
Middle Name:A
Last Name:LEIN
Suffix:
Gender:F
Credentials:PNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 7328
Mailing Address - Street 2:
Mailing Address - City:LOVELAND
Mailing Address - State:CO
Mailing Address - Zip Code:80537-0328
Mailing Address - Country:US
Mailing Address - Phone:970-663-2742
Mailing Address - Fax:970-667-0847
Practice Address - Street 1:4845 WEITZEL ST STE 101
Practice Address - Street 2:
Practice Address - City:TIMNATH
Practice Address - State:CO
Practice Address - Zip Code:80547-4800
Practice Address - Country:US
Practice Address - Phone:970-267-9510
Practice Address - Fax:970-207-9967
Is Sole Proprietor?:No
Enumeration Date:2006-10-11
Last Update Date:2022-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR200550172NP363LP0200X
NDR39460363LP0200X
COC-APN.0004362-C-NP363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
ND84294Medicaid
OR005739Medicaid
ORQ68434Medicare UPIN
ND84294Medicaid
NDN719522Medicare UPIN