| Organization Name: | LITTLE POUDRE FAMILY CLINIC, LLC |
| NPI Number: | 1336455997 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | KAREN A MCGRAW (FAMILY NURSE PRACTITIONER) |
| Mailing Address: | 3817 W County Road 54g Laporte |
| State: | CO US |
| Postal Code: | 805359360 |
| Phone Number: | 9704722001 |
| Fax Number: | 9702129336 |
| NPI Enumeration Date: | 08/20/2010 |
| NPI Last Update Date: | 09/22/2011 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QP2300X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | CO |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Primary Care |
| Taxonomy Definition: | |