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General NPI Number Information
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NPI Number | 1487390019
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Entity Type | Organization
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Legal Business Name | CLEAR CREEK COUNTY PUBLIC AND ENVIRONMENTAL HEALTH
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Dates
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Enumeration Date | 05/06/2022
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Last Update Date | 05/06/2022
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Provider Practice Location Address
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Address Line | 1969 MINER STREET
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City | IDAHO SPRINGS
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State | CO
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Zip | 80452
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Country | US
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Telephone | 303-670-7545
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 3669
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City | IDAHO SPRINGS
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State | CO
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Zip | 80452-3669
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Country | US
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Telephone | 303-670-7545
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Fax |
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Authorized Official
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Title or Position | MEDICAL PROVIDER FOR CLEAR CREEK
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Name | EMILY KUPER
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Credential | FNP
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Telephone | 303-670-5689
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251K00000X
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Taxonomy Name | Public Health or Welfare Agency
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License Number |
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License Number State |
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