Provider Demographics
NPI:1447544598
Name:DEKERLEGAND, KATIE (PHARMD)
Entity type:Individual
Prefix:
First Name:KATIE
Middle Name:
Last Name:DEKERLEGAND
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5071 KIPLING ST
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80033-2251
Mailing Address - Country:US
Mailing Address - Phone:303-209-1849
Mailing Address - Fax:
Practice Address - Street 1:7400 S GARTRELL RD
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80016-4236
Practice Address - Country:US
Practice Address - Phone:303-209-2929
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-07
Last Update Date:2021-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN26022442A183500000X
IL051.293858183500000X
COPHA-17802183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist