Doctor Name: | LERA VIRGINIA MAIN |
NPI Number: | 1356553119 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | LPN |
License Number: | 19741 |
Business Practice Address: | 600 South Drive Fort Collins, CO - 80521 |
Business Phone Number: | 9704911460 |
Business Fax Number: | |
Mailing Address: | 1028 W Oak St, FORT COLLINS |
State: | CO |
Postal Code: | 805212409 |
Phone Number: | |
Fax Number: | |
NPI Enumeration Date: | 05/04/2007 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 390200000X |
License Number: | 19741 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | CO |
Taxonomy Type: | Student, Health Care |
Taxonomy Classification: | Student in an Organized Health Care Education/Training Program |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care. |