MEDICARE: KATHLEEN RAMIREZ FNP

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	APN.09920652-NP	CO

General Provider Information

NPI Number	:	1750756896
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KATHLEEN RAMIREZ FNP

Provider Business Mailing Address
First Line	:	9611 COUNTY ROAD 57
Second Line	:
City	:	KEENESBURG
State	:	CO
Zip	:	80643-9646
Country	:	US
Telephone Number	:	303-345-5563
Fax Number	:

Provider Business Practice Location Address
First Line	:	931 LINCOLN ST
Second Line	:
City	:	FORT MORGAN
State	:	CO
Zip	:	80701-3366
Country	:	US
Telephone Number	:	970-867-1843
Fax Number	:

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

Provider Enumeration Date	:	12/01/2015
Last Update Date	:	12/01/2015

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