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General NPI Number Information
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NPI Number | 1164741807
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Entity Type | Organization
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Legal Business Name | PREMIERE HEALTHCARE ASSOCIATES LLC
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Dates
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Enumeration Date | 05/20/2010
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Last Update Date | 05/20/2010
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Provider Practice Location Address
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Address Line | 6310 UMBER CIR
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City | ARVADA
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State | CO
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Zip | 80403-7407
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Country | US
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Telephone | 303-277-9455
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Fax |
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Provider Business Mailing Address
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Address Line | 6310 UMBER CIR
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City | ARVADA
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State | CO
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Zip | 80403-7407
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Country | US
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Telephone | 303-277-9455
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. KATHLEEN GUTIERREZ
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Credential | PHD, RN, ANP-BC
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Telephone | 303-277-9455
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number | 51561
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License Number State | CO
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