Provider Demographics
NPI:1124287107
Name:INTERNAL MEDICINE OF THE ROCKIES
Entity type:Organization
Organization Name:INTERNAL MEDICINE OF THE ROCKIES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:NURSE PRACTITIONER
Authorized Official - Prefix:MRS
Authorized Official - First Name:ZAHRA
Authorized Official - Middle Name:NEKOUIES
Authorized Official - Last Name:HARRISON
Authorized Official - Suffix:
Authorized Official - Credentials:ANP
Authorized Official - Phone:719-389-0070
Mailing Address - Street 1:2875 INTERNATIONAL CIR
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80910-3144
Mailing Address - Country:US
Mailing Address - Phone:719-389-0070
Mailing Address - Fax:719-389-0071
Practice Address - Street 1:2875 INTERNATIONAL CIR
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80910-3144
Practice Address - Country:US
Practice Address - Phone:719-389-0070
Practice Address - Fax:719-389-0071
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-06-05
Last Update Date:2008-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO169423363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult HealthGroup - Single Specialty