Organization
OSHA HEALTHCARE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ELIZABETH ANN CULLEN FNP-BC (AGENT)
(303) 440-0642
Entity
Organization
Contact information
Practice address
49 DOUGLAS DR S, BROOMFIELD, CO 80020-1105
(303) 440-0642
Mailing address
49 DOUGLAS DR S, BROOMFIELD, CO 80020-1105
(303) 440-0642
Taxonomy
Speciality
Code
Description
License number
State
261QM1000X
Migrant Health Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
20201924585
CO SECRETARY OF STATE
CO
Enumeration date
11/09/2020
Last updated
07/16/2021
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