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General NPI Number Information
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NPI Number | 1538145289
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Entity Type | Individual
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Provider Name | LARA ABRAHAMSON MD
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Gender | Female
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Dates
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Enumeration Date | 12/15/2005
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Last Update Date | 09/19/2014
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Provider Practice Location Address
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Address Line | 1113 OAKRIDGE DR
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City | FORT COLLINS
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State | CO
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Zip | 80525-5591
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Country | US
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Telephone | 970-225-0040
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Fax | 970-221-5206
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Provider Business Mailing Address
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Address Line | 3702 AUTOMATION WAY SUITE 103
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City | FORT COLLINS
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State | CO
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Zip | 80525-5737
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Country | US
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Telephone | 970-224-1670
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Fax | 970-495-6218
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 41086
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License Number State | CO
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