Provider Demographics
NPI:1407833528
Name:MUELLER, LAURA JEAN (MD)
Entity Type:Individual
Prefix:
First Name:LAURA
Middle Name:JEAN
Last Name:MUELLER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10350 E DAKOTA AVE
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80247-1314
Mailing Address - Country:US
Mailing Address - Phone:303-338-4545
Mailing Address - Fax:
Practice Address - Street 1:1960 OGDEN ST
Practice Address - Street 2:SUITE 340
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80218-3666
Practice Address - Country:US
Practice Address - Phone:303-318-3830
Practice Address - Fax:303-318-3825
Is Sole Proprietor?:No
Enumeration Date:2005-12-29
Last Update Date:2013-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN32045207V00000X
CO50248207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO80054242Medicaid
CO022808OtherKAISER COMMERCIAL NUMBER
CO022808OtherKAISER COMMERCIAL NUMBER
COCOAAA4261Medicare PIN
CO80054242Medicaid