KATHLENE S WALLER, MD, Adolescent Medicine FORT COLLINS, CO

Contact Information

KATHLENE S WALLER, MD

HARTSHORN HEALTH SERVICE
COLORADO STATE UNIVERSITY
FORT COLLINS, CO 80523-8031

Phone: 970-491-7121
Fax: 970-491-0226
Website:

	Specialty	Taxonomy Code	Specialty Code	Provider Type
	Adolescent Medicine	2080A0000X	37	Physician/Pediatric Medicine

Indicates primary specialty

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NPI Profile & details for KATHLENE S WALLER · (Female)

NPI Number	`1023027778`
Status	Active
Credentials	MD
Entity	Individual
Enumeration date	08/05/2006
Last updated	07/08/2007 - About 19 years ago
Sole proprietor ¹	No
Identifiers	CO License # 30233
Hospital affiliation(s)	Not Available

¹ A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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