Provider Demographics
NPI:1396565644
Name:SUPERIOR MEDICINE, PLLC
Entity type:Organization
Organization Name:SUPERIOR MEDICINE, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO & PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:LORA
Authorized Official - Middle Name:
Authorized Official - Last Name:SHIMA
Authorized Official - Suffix:
Authorized Official - Credentials:FNP-C
Authorized Official - Phone:720-290-8243
Mailing Address - Street 1:435 S SNOWMASS CIR
Mailing Address - Street 2:
Mailing Address - City:SUPERIOR
Mailing Address - State:CO
Mailing Address - Zip Code:80027-6119
Mailing Address - Country:US
Mailing Address - Phone:720-290-8243
Mailing Address - Fax:
Practice Address - Street 1:435 S SNOWMASS CIR
Practice Address - Street 2:
Practice Address - City:SUPERIOR
Practice Address - State:CO
Practice Address - Zip Code:80027-6119
Practice Address - Country:US
Practice Address - Phone:720-290-8243
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-10-11
Last Update Date:2024-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty