Individual provider Active NPI

Sandra Kay Nebl, RN, MSN, ACNP

  • Acute Care Nurse Practitioner
  • Pueblo, CO
National Provider Identifier
1144342106
Registry record updated Mar 14, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
84013 Issued in CO
Practice address
1600 N. Grand Ave.
Ste 260
Pueblo, CO 81003-2729
Phone
(719) 562-2010
Fax
(719) 562-2097
NPI assigned
Apr 3, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 14, 2017

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X 84013 CO Primary

Addresses

Primary practice location

1600 N. Grand Ave.
Ste 260
Pueblo, CO 81003-2729

Mailing address

PO Box 560825
Denver, CO 80256-0825
Phone (719) 595-7580

Other identifiers 1

IdentifierTypeStateIssuer
07840135MedicaidCO

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science - Nursing, Nurse Practitioner, Registered Nurse

State licenses

LicenseStateTypeSpecialty
84013COMDAcute Care Nurse Practitioner

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1175558400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1489449600000",
    "number": "1144342106",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 560825",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802560825",
            "telephone_number": "719-595-7580",
            "fax_number": "719-542-0809"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1600 N. GRAND AVE.",
            "address_2": "STE 260",
            "city": "PUEBLO",
            "state": "CO",
            "postal_code": "810032729",
            "telephone_number": "719-562-2010",
            "fax_number": "719-562-2097"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NEBL",
        "first_name": "SANDRA",
        "middle_name": "KAY",
        "name_prefix": "Ms.",
        "credential": "RN, MSN, ACNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-04-03",
        "last_updated": "2017-03-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "CO",
            "license": "84013",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "07840135",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Pueblo, CO

Sources for this page

Verify at the official NPI Registry.