Provider Demographics
NPI:1922334937
Name:ALUMBAUGH, CLARISSA RACHELE (NP)
Entity Type:Individual
Prefix:
First Name:CLARISSA
Middle Name:RACHELE
Last Name:ALUMBAUGH
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1334 N TABOR DR
Mailing Address - Street 2:
Mailing Address - City:CASTLE ROCK
Mailing Address - State:CO
Mailing Address - Zip Code:80104-8996
Mailing Address - Country:US
Mailing Address - Phone:303-766-0197
Mailing Address - Fax:
Practice Address - Street 1:1 OAKWOOD PARK PLZ STE 206
Practice Address - Street 2:
Practice Address - City:CASTLE ROCK
Practice Address - State:CO
Practice Address - Zip Code:80104-1849
Practice Address - Country:US
Practice Address - Phone:720-924-2548
Practice Address - Fax:303-814-1390
Is Sole Proprietor?:No
Enumeration Date:2009-10-26
Last Update Date:2020-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO129798363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO84625562Medicaid