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:
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Health care specialties

SpecialtyCodeLicense #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 11 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1538113105 NPPES
Colorado MEDICAID 46559043

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