=====================================================
General NPI Number Information
=====================================================
NPI Number | 1952951410
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | MARGARET LAURA GLOOR
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 09/17/2019
-----------------------------------------------------
Last Update Date | 09/17/2019
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 405 CASTLE CREEK RD STE 201
-----------------------------------------------------
City | ASPEN
-----------------------------------------------------
State | CO
-----------------------------------------------------
Zip | 81611-3125
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 970-920-5424
-----------------------------------------------------
Fax | 970-920-5419
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 405 CASTLE CREEK RD STE 201
-----------------------------------------------------
City | ASPEN
-----------------------------------------------------
State | CO
-----------------------------------------------------
Zip | 81611-3125
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 970-920-5420
-----------------------------------------------------
Fax | 970-920-5419
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 163WC1500X
-----------------------------------------------------
Taxonomy Name | Community Health Registered Nurse
-----------------------------------------------------
License Number | RN.0190222
-----------------------------------------------------
License Number State | CO
-----------------------------------------------------