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NPI Code Detail

MEDICARE: PAULA JEAN WHITEHORN REGISTERED NURSE

MEDICARE: PAULA JEAN WHITEHORN REGISTERED NURSE
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
1163WC1500XCommunity Health Registered Nurse43181CO

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1164689998
Entity Type Code : Individual
Provider Name (Legal Business Name) : PAULA JEAN WHITEHORN REGISTERED NURSE
Provider Business Mailing Address
First Line : 172 JUSTICE CENTER RD
Second Line :
City : CANON CITY
State : CO
Zip : 81212-9354
Country : US
Telephone Number : 719-275-1626
Fax Number :
Provider Business Practice Location Address
First Line : 172 JUSTICE CENTER RD
Second Line :
City : CANON CITY
State : CO
Zip : 81212-9354
Country : US
Telephone Number : 719-275-1626
Fax Number : 719-275-4328
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/20/2008
Last Update Date : 05/20/2008

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Directions to “ PAULA JEAN WHITEHORN REGISTERED NURSE” Practice Location

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