1548334873 NPI number — KAREN PRIEST BARRETT

Table of content: KAREN PRIEST BARRETT (NPI 1548334873)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1548334873 NPI number — KAREN PRIEST BARRETT

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
PRIEST BARRETT
Provider First Name:
KAREN
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
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:
1548334873
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
02/28/2014
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
9750 S WARHAWK RD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
CONIFER
Provider Business Mailing Address State Name:
CO
Provider Business Mailing Address Postal Code:
80433-9324
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
303-838-6889
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
8550 W 38TH AVE
Provider Second Line Business Practice Location Address:
SUITE 106B
Provider Business Practice Location Address City Name:
WHEAT RIDGE
Provider Business Practice Location Address State Name:
CO
Provider Business Practice Location Address Postal Code:
80033-4341
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
303-953-3163
Provider Business Practice Location Address Fax Number:
303-245-0726
Provider Enumeration Date:
11/20/2006

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: 225X00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 0000798 . This is a "STATE LICENSE" identifier , issued by the state of ( CO ) . This identifiers is of the category "OTHER".




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