Provider Demographics
NPI:1225428899
Name:MCLEOD, AMBERRAE
Entity Type:Individual
Prefix:
First Name:AMBERRAE
Middle Name:
Last Name:MCLEOD
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:960 GRANT ST # 726
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80203-2907
Mailing Address - Country:US
Mailing Address - Phone:303-947-3932
Mailing Address - Fax:303-997-4631
Practice Address - Street 1:960 GRANT ST # 726
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80203-2907
Practice Address - Country:US
Practice Address - Phone:303-947-3932
Practice Address - Fax:303-997-4631
Is Sole Proprietor?:Yes
Enumeration Date:2015-02-03
Last Update Date:2015-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory
No172V00000XOther Service ProvidersCommunity Health Worker