1316928542 NPI number — MRS. TAMRA MARIE MEURER FNP-BC

Table of content: MRS. TAMRA MARIE MEURER FNP-BC (NPI 1316928542)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1316928542 NPI number — MRS. TAMRA MARIE MEURER FNP-BC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
MEURER
Provider First Name:
TAMRA
Provider Middle Name:
MARIE
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
FNP-BC
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1316928542
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
03/22/2016
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1137 WYNDHAM HILL RD
Provider Second Line Business Mailing Address:
SUITE 2
Provider Business Mailing Address City Name:
FORT COLLINS
Provider Business Mailing Address State Name:
CO
Provider Business Mailing Address Postal Code:
80525-7201
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
970-388-5588
Provider Business Mailing Address Fax Number:
970-282-0824

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1236 E ELIZABETH ST
Provider Second Line Business Practice Location Address:
SUITE 2
Provider Business Practice Location Address City Name:
FORT COLLINS
Provider Business Practice Location Address State Name:
CO
Provider Business Practice Location Address Postal Code:
80524-4000
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
970-488-1668
Provider Business Practice Location Address Fax Number:
970-472-9381
Provider Enumeration Date:
11/05/2005

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:  RN.0076875 , 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: 07768757 , issued by the state of ( CO ) . This identifiers is of the category "MEDICAID".
  • Identifier: 10025181600 , issued by the state of ( NE ) . This identifiers is of the category "MEDICAID".
  • Identifier: P00314037 . This is a "MEDICARE CO RR-GSNC INDIV" identifier , issued by the state of ( CO ) . This identifiers is of the category "OTHER".
  • Identifier: 500015349 . This is a "RR MEDICARE" identifier , issued by the state of ( CO ) . This identifiers is of the category "OTHER".
  • Identifier: 651431 . This is a "BCBS" identifier , issued by the state of ( CO ) . This identifiers is of the category "OTHER".
  • Identifier: P01086321 . This is a "MEDICARE CO RR-RMIDC INDIV" identifier , issued by the state of ( CO ) . This identifiers is of the category "OTHER".




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