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General NPI Number Information
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NPI Number | 1609508845
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Entity Type | Organization
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Legal Business Name | GORMAN MEDICAL LLC
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Dates
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Enumeration Date | 06/27/2022
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Last Update Date | 09/06/2023
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Provider Practice Location Address
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Address Line | 412 N C ST
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City | CRIPPLE CREEK
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State | CO
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Zip | 80813-5052
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Country | US
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Telephone | 719-358-8270
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Fax | 719-358-8299
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Provider Business Mailing Address
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Address Line | PO BOX 62669
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City | COLORADO SPRINGS
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State | CO
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Zip | 80962-2669
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Country | US
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Telephone | 719-219-2400
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Fax | 719-219-2409
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Authorized Official
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Title or Position | AUTHORIZED OFFICIAL / OWNER
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Name | MS. FRANCES J GORMAN
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Credential | NP
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Telephone | 719-313-6028
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LS0200X
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Taxonomy Name | School Nurse Practitioner
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License Number |
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License Number State |
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