Healthcare Provider Details

I. General information

NPI: 1255574398
Provider Name (Legal Business Name): KAREN A MCGRAW F.N.P.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/17/2009
Last Update Date: 11/15/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3817 W COUNTY ROAD 54G
LAPORTE CO
80535-9360
US

IV. Provider business mailing address

3817 W COUNTY ROAD 54G
LAPORTE CO
80535-9360
US

V. Phone/Fax

Practice location:
  • Phone: 970-472-2001
  • Fax: 970-212-9336
Mailing address:
  • Phone: 970-472-2001
  • Fax: 970-212-9336

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberNP 10019
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: