Provider Demographics
NPI:1932722469
Name:KLIMEK, NATHANIEL R (PARAMEDIC)
Entity Type:Individual
Prefix:MR
First Name:NATHANIEL
Middle Name:R
Last Name:KLIMEK
Suffix:
Gender:M
Credentials:PARAMEDIC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4666 CRESTONE PEAK ST
Mailing Address - Street 2:
Mailing Address - City:BRIGHTON
Mailing Address - State:CO
Mailing Address - Zip Code:80601-4581
Mailing Address - Country:US
Mailing Address - Phone:570-237-6518
Mailing Address - Fax:
Practice Address - Street 1:303 S MAIN ST
Practice Address - Street 2:
Practice Address - City:PLATTEVILLE
Practice Address - State:CO
Practice Address - Zip Code:80651
Practice Address - Country:US
Practice Address - Phone:570-237-6518
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-05-19
Last Update Date:2020-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO050887146L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes146L00000XEmergency Medical Service ProvidersEmergency Medical Technician, Paramedic
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO050887OtherCDPHE