1750705794 NPI number — RAMONA SUZANNE DENK WEBB CPM, RM

Table of content: PHILLIP ELVIS MD (NPI 1275263402)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1750705794 NPI number — RAMONA SUZANNE DENK WEBB CPM, RM

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
WEBB
Provider First Name:
RAMONA
Provider Middle Name:
SUZANNE DENK
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
CPM, RM
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
DENK
Provider Other First Name:
RAMONA
Provider Other Middle Name:
SUZANNE
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
CPM
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1750705794
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
02/11/2014
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
7702 BARNES RD
Provider Second Line Business Mailing Address:
#140-80
Provider Business Mailing Address City Name:
COLORADO SPRINGS
Provider Business Mailing Address State Name:
CO
Provider Business Mailing Address Postal Code:
80922-3514
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
719-445-8805
Provider Business Mailing Address Fax Number:
719-466-6511

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
6180 LEHMAN DR
Provider Second Line Business Practice Location Address:
103
Provider Business Practice Location Address City Name:
COLORADO SPRINGS
Provider Business Practice Location Address State Name:
CO
Provider Business Practice Location Address Postal Code:
80918-3444
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
719-445-8805
Provider Business Practice Location Address Fax Number:
719-466-6511
Provider Enumeration Date:
02/11/2014

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: 176B00000X , with the licence number:  MWR.0000152 , 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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