Individual
DR. LORAINE LYNN CARROLL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1600 N GRAND AVE, SUITE 240, PUEBLO, CO 81003-2700
(719) 296-2305
(719) 295-2320
Mailing address
1600 N GRAND AVE, SUITE 240, PUEBLO, CO 81003-2700
(719) 296-2305
(719) 295-2320
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
36942
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01369420
—
CO
01
—
CA604838
BCBS
—
Enumeration date
07/07/2006
Last updated
11/02/2007
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