Provider Demographics
NPI:1912264573
Name:DIRECT NP LLC
Entity Type:Organization
Organization Name:DIRECT NP LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FOUNDER
Authorized Official - Prefix:
Authorized Official - First Name:LAURA
Authorized Official - Middle Name:ORNOWSKI
Authorized Official - Last Name:HILDEBRAND
Authorized Official - Suffix:
Authorized Official - Credentials:ANP
Authorized Official - Phone:970-219-6701
Mailing Address - Street 1:417 S HOWES ST
Mailing Address - Street 2:
Mailing Address - City:FORT COLLINS
Mailing Address - State:CO
Mailing Address - Zip Code:80521-2801
Mailing Address - Country:US
Mailing Address - Phone:970-219-6701
Mailing Address - Fax:970-419-0997
Practice Address - Street 1:417 S HOWES ST
Practice Address - Street 2:
Practice Address - City:FORT COLLINS
Practice Address - State:CO
Practice Address - Zip Code:80521-2801
Practice Address - Country:US
Practice Address - Phone:970-219-6701
Practice Address - Fax:970-419-0997
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-04-19
Last Update Date:2012-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO20121130241261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center