Katherine Suzanne Klockau, PHARM.D.
Individual provider Active NPI Pharmacist · Fraser, CO
NPI 1104173756 · NPPES record last updated Aug 13, 2012
Key facts
- NPI
- 1104173756
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist 183500000X
- License
- 19540 (CO)
- Practice address
- 40 County Road
#804
Fraser, CO 80442-0218 - Phone
- (970) 726-6920
- Fax
- (970) 726-6836
- NPI assigned
- Aug 13, 2012
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Doctor of Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 19540 | CO | MD | Pharmacist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 19540 | CO | Yes |
Addresses
Primary practice location
40 County Road
#804
Fraser, CO 80442-0218
Mailing address
40 County Road #804
Fraser, CO 80442-0218
Phone (970) 726-6920
Other providers in Fraser, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 13, 2012. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.