1649557950 NPI number — ANDREA LAMB N.P.

Table of content: ANDREA LAMB N.P. (NPI 1649557950)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1649557950 NPI number — ANDREA LAMB N.P.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
LAMB
Provider First Name:
ANDREA
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
N.P.
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:
1649557950
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
09/17/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2643 PATTERSON RD
Provider Second Line Business Mailing Address:
SUITE 605
Provider Business Mailing Address City Name:
GRAND JUNCTION
Provider Business Mailing Address State Name:
CO
Provider Business Mailing Address Postal Code:
81506-1936
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
970-298-2482
Provider Business Mailing Address Fax Number:
970-298-1701

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2643 PATTERSON RD
Provider Second Line Business Practice Location Address:
SUITE 605
Provider Business Practice Location Address City Name:
GRAND JUNCTION
Provider Business Practice Location Address State Name:
CO
Provider Business Practice Location Address Postal Code:
81506-1936
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
970-298-2482
Provider Business Practice Location Address Fax Number:
970-298-1701
Provider Enumeration Date:
11/15/2011

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: 363L00000X , with the licence number:  15669 , registered in the state of WI ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 363LF0000X , with the licence number: NP-990239 , 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: 100287870 , issued by the state of ( WI ) . This identifiers is of the category "MEDICAID".




Copyright © 2007-2025 www.npivalidator.com