Provider Demographics
NPI:1487390019
Name:CLEAR CREEK COUNTY PUBLIC AND ENVIRONMENTAL HEALTH
Entity type:Organization
Organization Name:CLEAR CREEK COUNTY PUBLIC AND ENVIRONMENTAL HEALTH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL PROVIDER FOR CLEAR CREEK
Authorized Official - Prefix:
Authorized Official - First Name:EMILY
Authorized Official - Middle Name:
Authorized Official - Last Name:KUPER
Authorized Official - Suffix:
Authorized Official - Credentials:FNP
Authorized Official - Phone:303-670-5689
Mailing Address - Street 1:PO BOX 3669
Mailing Address - Street 2:
Mailing Address - City:IDAHO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80452-3669
Mailing Address - Country:US
Mailing Address - Phone:303-670-7545
Mailing Address - Fax:
Practice Address - Street 1:1969 MINER STREET
Practice Address - Street 2:
Practice Address - City:IDAHO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80452
Practice Address - Country:US
Practice Address - Phone:303-670-7545
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-05-06
Last Update Date:2022-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251K00000XAgenciesPublic Health or Welfare