Provider Demographics
NPI:1770155665
Name:AFFIRMATIVE CARE, P.C.
Entity type:Organization
Organization Name:AFFIRMATIVE CARE, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINIC DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:JULIE
Authorized Official - Middle Name:
Authorized Official - Last Name:PUTT
Authorized Official - Suffix:
Authorized Official - Credentials:NP
Authorized Official - Phone:646-820-7879
Mailing Address - Street 1:4664 PALMER CT
Mailing Address - Street 2:
Mailing Address - City:LONGMONT
Mailing Address - State:CO
Mailing Address - Zip Code:80503-8339
Mailing Address - Country:US
Mailing Address - Phone:614-403-2833
Mailing Address - Fax:888-655-0677
Practice Address - Street 1:1067 S HOVER ST STE E-2032
Practice Address - Street 2:
Practice Address - City:LONGMONT
Practice Address - State:CO
Practice Address - Zip Code:80501-7904
Practice Address - Country:US
Practice Address - Phone:888-292-0799
Practice Address - Fax:888-655-0677
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-07-12
Last Update Date:2021-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Multi-Specialty
No363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult HealthGroup - Multi-Specialty