1962441402 NPI number — MRS. TAMRA ELIZABETH CARTER RNC, MS, NNP

Table of content: MRS. TAMRA ELIZABETH CARTER RNC, MS, NNP (NPI 1962441402)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1962441402 NPI number — MRS. TAMRA ELIZABETH CARTER RNC, MS, NNP

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
CARTER
Provider First Name:
TAMRA
Provider Middle Name:
ELIZABETH
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
RNC, MS, NNP
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
WILLE
Provider Other First Name:
TAMRA
Provider Other Middle Name:
ELIZABETH
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1962441402
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/08/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2468 MCKAY LANDING PKWY
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
BROOMFIELD
Provider Business Mailing Address State Name:
CO
Provider Business Mailing Address Postal Code:
80020-6518
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
303-469-6096
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1601 E 19TH AVE
Provider Second Line Business Practice Location Address:
SUITE 5300
Provider Business Practice Location Address City Name:
DENVER
Provider Business Practice Location Address State Name:
CO
Provider Business Practice Location Address Postal Code:
80218-1216
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
303-839-7440
Provider Business Practice Location Address Fax Number:
303-839-7210
Provider Enumeration Date:
06/06/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 363LN0005X , with the licence number:  118923 , registered in the state of CO ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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