Organization
CROSSROADS MEDICAL CENTER
Active
Other names
Crossroads Medical Center LLC, Carl A Mortiz JR MBR
Organization subpart
No
Provider details
NPI number
Authorized official
MS. LAUREN JASILLI FNP-C (PRACTICE OWNER)
(303) 444-6400
Entity
Organization
Contact information
Practice address
2760 29TH ST STE 2B, BOULDER, CO 80301-1221
(303) 444-6400
(303) 444-6465
Mailing address
2760 29TH ST STE 2B, BOULDER, CO 80301-1221
(303) 444-6400
(303) 444-6465
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0126399
—
CO
Enumeration date
06/25/2020
Last updated
09/27/2024
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