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NPI Code Detail

MEDICARE: KARLA MARIE DETERS

MEDICARE: KARLA MARIE DETERS
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
1171M00000XCase Manager/Care Coordinator

General Provider Information

NPI Number : 1366746935
Entity Type Code : Individual
Provider Name (Legal Business Name) : KARLA MARIE DETERS
Provider Business Mailing Address
First Line : 1440 GROVE ST UNIT A
Second Line :
City : DENVER
State : CO
Zip : 80204-2201
Country : US
Telephone Number : 303-504-1555
Fax Number :
Provider Business Practice Location Address
First Line : 1440 GROVE ST UNIT A
Second Line :
City : DENVER
State : CO
Zip : 80204-2201
Country : US
Telephone Number : 303-504-1555
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/22/2010
Last Update Date : 12/22/2010

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Directions to “ KARLA MARIE DETERS ” Practice Location

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