Healthcare Provider Details

I. General information

NPI: 1508401712
Provider Name (Legal Business Name): COUNTY OF LARIMER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/12/2019
Last Update Date: 11/12/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1601 BRODIE AVE
ESTES PARK CO
80517-7486
US

IV. Provider business mailing address

1525 BLUE SPRUCE DR
FORT COLLINS CO
80524-2004
US

V. Phone/Fax

Practice location:
  • Phone: 970-577-2050
  • Fax:
Mailing address:
  • Phone: 970-498-6719
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251K00000X
TaxonomyPublic Health or Welfare Agency
License Number
License Number State

VIII. Authorized Official

Name: CHRISTINE ROSE NEVIN-WOODS
Title or Position: MEDICAL DIRECTOR
Credential: DO
Phone: 970-498-6719