LITTLE POUDRE FAMILY CLINIC LLC NPI 1336455997

NPI Information

NPI: 1336455997
Provider Name: LITTLE POUDRE FAMILY CLINIC, LLC

Former Legal Business Name: LITTLE POUDRE FAMILY CARE

Classification: Clinic/Center - 261QP2300X
Entity Type: Organization

Specialization: Primary Care

Address:
3817 W COUNTY ROAD 54G
LAPORTE, CO
ZIP 80535
Phone: (970) 472-2001
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LITTLE POUDRE FAMILY CLINIC, LLC is a primary care clinic center in Laporte, CO. LITTLE POUDRE FAMILY CLINIC, LLC NPI is 1336455997. The provider is registered as an organization entity type.
The provider Former Legal Business Name Is Little Poudre Family Care.

The provider's business location address is:

3817 W COUNTY ROAD 54G
LAPORTE, CO
ZIP 80535-360
Phone: (970) 472-2001
Fax: (970) 212-9336

The provider's authorized official is Karen A Mcgraw .
The authorized official title is Family Nurse Practitioner and has the following contact phone number (970) 472-2001.

The enumeration date for this NPI number is 8/20/2010 and was last updated on 9/22/2011.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	261QP2300X	Clinic/Center	Primary Care		COLORADO	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	46455361	MEDICAID	COLORADO

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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