Provider Demographics
NPI:1285722256
Name:GAREY, CLARA J (NP)
Entity type:Individual
Prefix:MRS
First Name:CLARA
Middle Name:J
Last Name:GAREY
Suffix:
Gender:F
Credentials:NP
Other - Prefix:MISS
Other - First Name:CLARA
Other - Middle Name:J
Other - Last Name:FICCO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:NP
Mailing Address - Street 1:601 E HAMPDEN AVE
Mailing Address - Street 2:#470
Mailing Address - City:ENGLEWOOD
Mailing Address - State:CO
Mailing Address - Zip Code:80113-3781
Mailing Address - Country:US
Mailing Address - Phone:303-789-1877
Mailing Address - Fax:303-789-2628
Practice Address - Street 1:601 E HAMPDEN AVE
Practice Address - Street 2:#470
Practice Address - City:ENGLEWOOD
Practice Address - State:CO
Practice Address - Zip Code:80113-3781
Practice Address - Country:US
Practice Address - Phone:303-789-1877
Practice Address - Fax:303-789-2628
Is Sole Proprietor?:No
Enumeration Date:2006-10-11
Last Update Date:2011-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO115151363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO17488079Medicaid
CO17488079Medicaid
P83666Medicare UPIN