Provider Demographics
NPI:1124404363
Name:REIMERS, CAROL ANN (APN)
Entity Type:Individual
Prefix:
First Name:CAROL
Middle Name:ANN
Last Name:REIMERS
Suffix:
Gender:F
Credentials:APN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3676 PARKER BLVD STE 320
Mailing Address - Street 2:
Mailing Address - City:PUEBLO
Mailing Address - State:CO
Mailing Address - Zip Code:81008-2213
Mailing Address - Country:US
Mailing Address - Phone:719-696-9828
Mailing Address - Fax:719-696-9862
Practice Address - Street 1:3676 PARKER BLVD STE 320
Practice Address - Street 2:
Practice Address - City:PUEBLO
Practice Address - State:CO
Practice Address - Zip Code:81008-2213
Practice Address - Country:US
Practice Address - Phone:719-696-9828
Practice Address - Fax:719-696-9862
Is Sole Proprietor?:No
Enumeration Date:2015-08-10
Last Update Date:2015-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COAPN.0991797-NP363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner