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NPI Code Detail

MEDICARE: HOLLEY CABALLES HARRIS

MEDICARE: HOLLEY CABALLES HARRIS
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1367500000XCertified Registered Nurse AnesthetistC-APN.0001411-C-CRNACO

General Provider Information

NPI Number : 1063551018
Entity Type Code : Individual
Provider Name (Legal Business Name) : HOLLEY CABALLES HARRIS
Provider Business Mailing Address
First Line : 3702 S TIMBERLINE RD STE A
Second Line :
City : FORT COLLINS
State : CO
Zip : 80525-3625
Country : US
Telephone Number : 970-207-9773
Fax Number : 970-207-1893
Provider Business Practice Location Address
First Line : 2555 E 13TH ST STE 220
Second Line :
City : LOVELAND
State : CO
Zip : 80537-5136
Country : US
Telephone Number : 970-669-5432
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/06/2007
Last Update Date : 09/22/2021

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Directions to “ HOLLEY CABALLES HARRIS ” Practice Location

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