Individual
MS. MARY BARGHELAME
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP-C
Contact information
Practice address
1455 MAIN ST, SUIT 100, WINDSOR, CO 80550-5559
(970) 686-3950
(970) 686-3960
Mailing address
1455 MAIN ST, SUIT 100, WINDSOR, CO 80550-5559
(970) 686-3950
(970) 686-3960
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN-88446
CO
363L00000X
Nurse Practitioner
NP-1596
CO
363LF0000X
Family Nurse Practitioner
Primary
NP-1596
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
46622837
—
CO
01
—
P00944852
MEDICARE RAILROAD CARRIER PTAN
CO
Enumeration date
01/31/2006
Last updated
06/15/2020
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