Organization Name: | PRAIRIE VIEW FAMILY CARE, LLC |
NPI Number: | 1902176704 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | KAREN JILL MIGLIACCIO (FAMILY NURSE PRACTITIONER/OWNER) |
Mailing Address: | 7641 Mclaughlin Rd Falcon |
State: | CO US |
Postal Code: | 808314715 |
Phone Number: | 7196615886 |
Fax Number: | |
NPI Enumeration Date: | 01/10/2012 |
NPI Last Update Date: | 01/10/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 261QP2300X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Ambulatory Health Care Facilities |
Taxonomy Classification: | Clinic/Center |
Taxonomy Specialization: | Primary Care |
Taxonomy Definition: |