Healthcare Provider Details

I. General information

NPI: 1720883929
Provider Name (Legal Business Name): MARCIA NEIMAN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/13/2025
Last Update Date: 02/13/2025
Certification Date: 02/13/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

PO BOX 17244
BOULDER CO
80308-0244
US

IV. Provider business mailing address

PO BOX 17244
BOULDER CO
80308-0244
US

V. Phone/Fax

Practice location:
  • Phone: 303-885-1368
  • Fax:
Mailing address:
  • Phone: 303-885-1368
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171R00000X
TaxonomyInterpreter
License Number
License Number State

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: