1912324971 NPI number — MRS. ELIZABETH KREGAR MSW

Table of content: MRS. ELIZABETH KREGAR MSW (NPI 1912324971)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1912324971 NPI number — MRS. ELIZABETH KREGAR MSW

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
KREGAR
Provider First Name:
ELIZABETH
Provider Middle Name:
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
MSW
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
GRAY
Provider Other First Name:
ELIZABETH
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
MSW
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1912324971
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
03/27/2014
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
715 HORIZON DR
Provider Second Line Business Mailing Address:
STE 225
Provider Business Mailing Address City Name:
GRAND JUNCTION
Provider Business Mailing Address State Name:
CO
Provider Business Mailing Address Postal Code:
81506-8700
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
970-683-7107
Provider Business Mailing Address Fax Number:
970-683-7167

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
407 SOUTH LINCOLN AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
STEAMBOAT SPRINGS
Provider Business Practice Location Address State Name:
CO
Provider Business Practice Location Address Postal Code:
80487
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
970-879-2141
Provider Business Practice Location Address Fax Number:
970-879-7912
Provider Enumeration Date:
03/27/2014

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: 101YM0800X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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