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Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.

DR. KATHLENE SUE WALLER, M.D.

Active

DR. KATHLENE SUE WALLER, M.D. is a Adolescent Medicine (Pediatrics) healthcare provider located in FORT COLLINS, Colorado. NPI 1023027778 is currently active in the NPPES registry. Verify at CMS.

Adolescent Medicine (Pediatrics) · FORT COLLINS, CO

Registration Details

NPI Number
1023027778
Provider Type
Individual
Gender
Female
NPI Issued
Aug 5, 2006 (20.055090914545 yrs)
Last Updated
Jul 8, 2007
License
30233 (CO)

Practice Information

Address
HARTSHORN HEALTH SERVICE
COLORADO STATE UNIVERSITY
FORT COLLINS, CO, 805238031
Browse CO providers · Browse ZIP 80523
Phone
9704917121
Fax
9704910226
Primary Specialty
Adolescent Medicine (Pediatrics)
2080A0000X
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.