Healthcare Provider Details

I. General information

NPI: 1275179228
Provider Name (Legal Business Name): DODIE DEMING NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/25/2019
Last Update Date: 03/20/2023
Certification Date: 03/20/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

221 E 29TH ST STE 202
LOVELAND CO
80538-2746
US

IV. Provider business mailing address

221 E 29TH ST STE 202
LOVELAND CO
80538-2746
US

V. Phone/Fax

Practice location:
  • Phone: 970-203-7050
  • Fax: 970-203-7055
Mailing address:
  • Phone: 970-203-7050
  • Fax: 970-203-7055

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License NumberAPN.0994789-NP
License Number StateCO
# 2
Primary TaxonomyN
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License NumberAPN.0994789-NP
License Number StateCO
# 3
Primary TaxonomyN
Taxonomy Code363LG0600X
TaxonomyGerontology Nurse Practitioner
License NumberAPN.0994789-NP
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: