Organization
POUDRE VALLEY MEDICAL GROUP, LLC
Active
Parent organization
POUDRE VALLEY MEDICAL GROUP, LLC
Other names
UCHealth Medical Group
Organization subpart
Yes
Provider details
NPI number
Legal business name
POUDRE VALLEY MEDICAL GROUP, LLC
Authorized official
JANA CONROY (DIRECTOR OF CREDENTIALING)
(720) 718-7000
Entity
Organization
Contact information
Practice address
1750 E KEN PRATT BLVD, LONGMONT, CO 80504-5311
(720) 718-7000
(720) 718-0900
Mailing address
2695 ROCKY MOUNTAIN AVE STE 150, LOVELAND, CO 80538-9071
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
—
—
207RH0002X
Hospice and Palliative Medicine (Internal Medicine) Physician
—
—
208M00000X
Hospitalist Physician
Primary
—
—
261QE0002X
Emergency Care Clinic/Center
—
—
363LN0000X
Neonatal Nurse Practitioner
—
—
Other
Enumeration date
10/22/2020
Last updated
08/19/2024
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