Ideal Family Medicine, Ltd

LBN: Ideal Family Medicine, Ltd
Ideal Family Medicine, Ltd is an health care organization with primary practice located at 1910 Lake Ave , Pueblo CO 81004-3322. The organization recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Family, which is considered as the primary health care specialty. Ideal Family Medicine, Ltd can be contacted via phone (719) 582-1489, or through Bryant, Jade via phone (719) 582-1489.

Contact Information

Primary practice address
1910 Lake Ave Pueblo CO 81004-3322
Phone: (719) 582-1489
Fax: (719) 434-9807
Website:
Map and Directions
Authorized official contact:
Name: Bryant, Jade FNP-BC
Phone: (719) 582-1489

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X 0992962 Colorado

Profile Details

NPI number 1255865713
LBN Legal business name Ideal Family Medicine, Ltd
DBA Doing business as
Authorized official Bryant, Jade FNP-BC
Entity Organization
Organization subpart 1 No
Enumeration date Apr 11th, 2017
Last updated Mar 4th, 2024 - about last year

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1255865713 NPPES
Colorado MEDICAID 1154861995

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