Raulie, Jeremy Michael
Raulie, Jeremy Michael is an individual health care provider with primary practice located at 2446 Research Pkwy Suite 200, Colorado Springs CO 80920-1087. He recently has 3 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, Physician Assistants & Advanced Practice Nursing Providers / Medical, Physician Assistants & Advanced Practice Nursing Providers / Surgical. Physician Assistants & Advanced Practice Nursing Providers / Surgical is his primary health care specialty. Raulie, Jeremy Michael can be contacted via phone (719) 623-1050.Contact Information
Primary practice address
2446 Research Pkwy Suite 200
Colorado Springs CO 80920-1087
Phone: (719) 623-1050
Fax: (719) 623-1052
Website:
Health care specialties
Specialty | Code | License # | State |
---|---|---|---|
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant | 363A00000X | CO1776 | Colorado |
Physician Assistants & Advanced Practice Nursing Providers / Medical | 363AM0700X | CO1776 | Colorado |
Physician Assistants & Advanced Practice Nursing Providers / Surgical | 363AS0400X | CO1776 | Colorado |
Profile Details
NPI number | 1538113105 |
---|---|
LBN Legal business name | Raulie, Jeremy Michael |
Credentials | PAC |
Entity | Individual |
Sole proprietor 1 | No |
Enumeration date | May 19th, 2006 |
Last updated | Nov 7th, 2014 - about 10 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
State | Type | Number | Issuer |
---|---|---|---|
All States | NPI | 1538113105 | NPPES |
Colorado | MEDICAID | 46559043 |
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