Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LN0000X | Nurse Practitioner - Neonatal | 68173 | CO |
NPI | 1104822469 |
---|---|
Provider Name | Karlene Ann Lambuth |
First Address | Grand Junction, CO 81501-8209 |
Second Address | Grand Junction, CO 81501-8209 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/06/2005 |
Last Update Date | 30/09/2014 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
07681737 | (05) | CO |