Individual
LYNNE PARKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CNM
Contact information
Practice address
300 COLORADO AVE, PUEBLO, CO 81004-2006
(719) 543-8711
(719) 543-5340
Mailing address
110 E ROUTT AVE, PUEBLO, CO 81004-2117
(719) 543-8718
(719) 543-5340
Taxonomy
Speciality
Code
Description
License number
State
176B00000X
Midwife
Primary
66089
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
810212
MEDICARE GROUP NUMBER
CO
01
—
87588820
MEDICAID GROUP NUMBER
CO
05
—
88229742
—
CO
Enumeration date
08/05/2006
Last updated
12/10/2013
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