Provider Demographics
NPI:1942337928
Name:TACINAS, CATHERINE R (RN)
Entity type:Individual
Prefix:
First Name:CATHERINE
Middle Name:R
Last Name:TACINAS
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1375 E 20TH AVE
Mailing Address - Street 2:4TH FLOOR IM
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80205-5423
Mailing Address - Country:US
Mailing Address - Phone:303-861-3490
Mailing Address - Fax:
Practice Address - Street 1:1375 EAST 20TH AVE
Practice Address - Street 2:SKYLINE 4TH FLOOR
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80205-1618
Practice Address - Country:US
Practice Address - Phone:303-861-3490
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-27
Last Update Date:2007-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO69843163WI0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WI0600XNursing Service ProvidersRegistered NurseInfection Control
Provider Identifiers
StateIdentifier IDID TypeIssuer
009003OtherKAISER-COMMERCIAL NUMBER