MEDICARE: MRS. KAREN LEIGH REA NP

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	363LF0000X	Family Nurse Practitioner	0990496-NP	CO

General Provider Information

NPI Number	:	1588917579
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. KAREN LEIGH REA NP

Provider Business Mailing Address
First Line	:	950 17TH ST STE 200
Second Line	:
City	:	DENVER
State	:	CO
Zip	:	80202-2803
Country	:	US
Telephone Number	:	303-292-9992
Fax Number	:	303-292-9970

Provider Business Practice Location Address
First Line	:	950 17TH ST STE 200
Second Line	:
City	:	DENVER
State	:	CO
Zip	:	80202-2803
Country	:	US
Telephone Number	:	303-292-9992
Fax Number	:	303-292-9970

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

Provider Enumeration Date	:	10/16/2012
Last Update Date	:	11/12/2013

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