Timberline Clinic, Inc.
Organization Active NPI Family Nurse Practitioner · Fairplay, CO
NPI 1861618191 · NPPES record last updated May 18, 2016
Key facts
- NPI
- 1861618191
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Family Nurse Practitioner 363LF0000X
- License
- 43262 (CO)
- Legal business name
- TIMBERLINE CLINIC, INC.
- Practice address
- 980 Main St.
Fairplay, CO 80440-0723 - Phone
- (719) 836-3455
- Fax
- (719) 836-1792
- NPI assigned
- Apr 17, 2007
- Organization subpart
- No
Authorized official
- Name
- Ms. Kathryn L. Young
- Title
- President
- Phone
- (719) 836-3455
National Provider Directory
Locations
3464 S Willow St
Ste 846
Denver, CO 80231
3464 S Willow St
#846
Denver, CO 80231
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner |
363LF0000X | 43262 | CO | Yes |
Addresses
Primary practice location
980 Main St.
Fairplay, CO 80440-0723
Mailing address
PO Box 723
980 Main St.
Fairplay, CO 80440-0723
Phone (719) 836-3455
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 01 | Other | CO | CO PACIFICARE |
| 500000326 | Other | CO | RAILROAD MEDICARE |
| SH29090 | Other | CO | CO BLUE SHIELD |
| 04008850 | Medicaid | CO | |
| 07100753 | Medicaid | CO | |
| YO634320 | Other | CO | CO BLUE SHIELD |
| 01219609 | Medicaid | CO |
Other providers in Fairplay, CO
- South Park Medical Group,PC
- Emma Jayne Spofford
- Dianne Marie Spomer
- Summit Community Care Clinic, Inc.
- Summit Community Care Clinic, Inc.
- Susan Hele Van Orden
- Jack Walsh
- Eileen Diana Webster
- Kristen Werner
- Linda Whitner
All providers in Fairplay, CO · Family Nurse Practitioner in Colorado
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 18, 2016. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.