1033394135 NPI number — LUCIA C LONDON ARNP

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1033394135 NPI number — LUCIA C LONDON ARNP

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
LONDON
Provider First Name:
LUCIA
Provider Middle Name:
C
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
ARNP
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
CALANDRA
Provider Other First Name:
LUCIA
Provider Other Middle Name:
M
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:
1033394135
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/17/2012
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 40000
Provider Second Line Business Mailing Address:
OCCUPATIONAL HEALTH
Provider Business Mailing Address City Name:
VAIL
Provider Business Mailing Address State Name:
CO
Provider Business Mailing Address Postal Code:
81658
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
970-569-7715
Provider Business Mailing Address Fax Number:
970-470-6697

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
230 CHAPEL PLACE
Provider Second Line Business Practice Location Address:
UNIT D101
Provider Business Practice Location Address City Name:
AVON
Provider Business Practice Location Address State Name:
CO
Provider Business Practice Location Address Postal Code:
81620
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
970-569-7715
Provider Business Practice Location Address Fax Number:
970-470-6697
Provider Enumeration Date:
01/08/2008

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: 363LF0000X , with the licence number:  ARNP1008572 , registered in the state of FL ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 363LX0106X , with the licence number: 990352 , 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)

  • Identifier: 3088669-00 , issued by the state of ( FL ) . This identifiers is of the category "MEDICAID".
  • Identifier: 480469761A , issued by the state of ( GA ) . This identifiers is of the category "MEDICAID".




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