Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207QH0002X | Family Doctor - Hospice and Palliative Medicine | 0001875 | CO |
N | 363LA2200X | Nurse Practitioner - Adult Health | 0001875 | CO |
NPI | 1255374849 |
---|---|
Provider Name | Lowell Anderson-Reitz |
First Address | Lafayette, CO 80026-3186 |
Second Address | Mead, CO 80542 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/06/2006 |
Last Update Date | 11/02/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
163236602 | (05) | TX |
163236603 | (05) | TX |
9000151171 | (05) | CO |
Q05326 | (02) | TX |