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NPI Code Detail

MEDICARE: KAREN C MACINTOSH APN, FNP

MEDICARE: KAREN C MACINTOSH APN, FNP
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363LA2100XAcute Care Nurse Practitioner186858CO
2363L00000XNurse Practitioner186858CO

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1186858OTHERCOLICENSE - RN/NP, MEDICARE PENDING

General Provider Information

NPI Number : 1720224900
Entity Type Code : Individual
Provider Name (Legal Business Name) : KAREN C MACINTOSH APN, FNP
Provider Business Mailing Address
First Line : 305 CARPENTER RD
Second Line :
City : FORT COLLINS
State : CO
Zip : 80525-4248
Country : US
Telephone Number : 970-663-3500
Fax Number : 970-292-0898
Provider Business Practice Location Address
First Line : 305 CARPENTER RD
Second Line :
City : FORT COLLINS
State : CO
Zip : 80525-4248
Country : US
Telephone Number : 970-663-3500
Fax Number : 970-292-0898
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/18/2008
Last Update Date : 06/25/2012

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