Provider Demographics
NPI:1194125559
Name:ABRAM, JOHN (FNP-BC)
Entity type:Individual
Prefix:
First Name:JOHN
Middle Name:
Last Name:ABRAM
Suffix:
Gender:M
Credentials:FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1501 W 13TH ST
Mailing Address - Street 2:
Mailing Address - City:LOVELAND
Mailing Address - State:CO
Mailing Address - Zip Code:80537-4440
Mailing Address - Country:US
Mailing Address - Phone:970-290-1361
Mailing Address - Fax:844-415-2182
Practice Address - Street 1:1501 W 13TH ST
Practice Address - Street 2:
Practice Address - City:LOVELAND
Practice Address - State:CO
Practice Address - Zip Code:80537-4440
Practice Address - Country:US
Practice Address - Phone:970-290-1361
Practice Address - Fax:844-415-2182
Is Sole Proprietor?:Yes
Enumeration Date:2014-09-03
Last Update Date:2021-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COAPN.0991004-NP363LF0000X
WY32684.1270363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily