MEDICARE: MRS. CARA ELISE FOLKERS

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
1	171M00000X	Case Manager/Care Coordinator		IL

General Provider Information

NPI Number	:	1447425541
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. CARA ELISE FOLKERS

Provider Business Mailing Address
First Line	:	7228 ATTU DR APT A
Second Line	:
City	:	FORT CARSON
State	:	CO
Zip	:	80902-2328
Country	:	US
Telephone Number	:	815-997-7523
Fax Number	:

Provider Business Practice Location Address
First Line	:	7228 ATTU DR APT A
Second Line	:
City	:	FORT CARSON
State	:	CO
Zip	:	80902-2328
Country	:	US
Telephone Number	:	815-997-7523
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/29/2008
Last Update Date	:	04/29/2008

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