| Florissant Family Medicine, Llc | |
|
18100 County Rd 1 Florissant CO 80816-9404 | |
| (719) 839-1923 | |
| (833) 539-1731 |
| Full Name | Florissant Family Medicine, Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 18100 County Rd 1, Florissant, Colorado |
| Authorized Official Name and Position | Deanna L Mcnulty (OWNER) |
| Authorized Official Contact | 7198391923 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Florissant Family Medicine, Llc Po Box 189 Florissant CO 80816-0189 Ph: (719) 839-1923 | Florissant Family Medicine, Llc 18100 County Rd 1 Florissant CO 80816-9404 Ph: (719) 839-1923 |
| NPI Number | 1871124248 |
|---|---|
| Provider Enumeration Date | 02/03/2020 |
| Last Update Date | 09/01/2022 |
| Medicare PECOS PAC ID | 0941637920 |
|---|---|
| Medicare Enrollment ID | O20200304001095 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1871124248 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | (* (Not Available)) | Primary |
| Provider Name | Deanna L Mcnulty |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1194208736 PECOS PAC ID: 3375574007 Enrollment ID: I20200304001336 |
| Provider Name | Vanessa S Sandlin |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1609536077 PECOS PAC ID: 2668864000 Enrollment ID: I20220118000042 |