ADVANCED PRACTICE HEADACHE AND PRIMARY CARE CLINIC (NPI# 1013490259) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1013490259 |
| Entity Type | Organization |
| Organization Name | ADVANCED PRACTICE HEADACHE AND PRIMARY CARE CLINIC |
| Other Organization Name | ZSUZSA GLASSCOCK |
| Practice Address |
1128 Eagleridge Blvd Pueblo CO 81008 |
| Mailing Address |
1128 Eagleridge Blvd Pueblo CO 81008-2103 |
| Practice Telephone | 7197781414 |
| Practice Fax Number | 7196741000 |
| Mailing Telephone | 7197781414 |
| Mailing Fax Number | 7196741000 |
| Enumeration Date | 2018-09-13 |
| Last Update Date | 2019-10-25 |
| Authorized Official Name | ZSUZSA GLASSCOCK (BUSINESS OWNER) |
| Authorized Official Telephone | 7197781414 |
| Authorized Official Credential | FNP |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
Physician Assistants & Advanced Practice Nursing Providers |
| Other Name | Type Code |
|---|---|
| Zsuzsa Glasscock | Doing Business As Name - Organization |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Colorado Business Entities | Advanced Practice Headache and Primary Care Clinic | 1128 Eagleridge Blvd, Pueblo, CO 81008 |
| Street Address |
1128 EAGLERIDGE BLVD |
| City | PUEBLO |
| State | CO |
| Zip Code | 81008 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083939474 | Zsuzsa Glasscock | Registered Nurse | 1128 Eagleridge Blvd, Pueblo, CO 81008-2103 | 2010-03-29 |
| 1497397657 | Advanced Practice Health Clinic | Clinic/Center | 1128 Eagleridge Blvd, Pueblo, CO 81008-2103 | 2019-10-09 |
| 1821338211 | Stacey Kay Molinar | Nurse Practitioner | 1128 Eagleridge Blvd, Pueblo, CO 81008-2103 | 2013-02-21 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164058913 | Healthone Clinic Services - Oncology Hematology LLC | Internal Medicine | 3678 Parker Blvd, Pueblo, CO 81008 | 2020-03-12 |
| 1073026423 | Carmel Community Living Corporation | Respite Care | 2003 Northmoor Terrace, Suite 100, Pueblo, CO 81008 | 2017-11-08 |
| 1568987121 | Hannah Vivian Roadruck | Pharmacist | 4200 Dillon Dr., Pueblo, CO 81008 | 2017-08-04 |
| 1184170425 | Brett Burana | Dentist | 729 Us-50, Pueblo, CO 81008 | 2016-08-28 |
| 1760832885 | Irby Dental Cottage | Dental Hygienist | 2099 West St # 50, Suite 180, Pueblo, CO 81008 | 2016-06-20 |
| 1649624362 | Curley Peak Dentistry Pllc | Dentist | 1640 W Fortino Blvd, Pueblo, CO 81008 | 2016-04-19 |
| 1336507847 | Kyle Tipton | Nurse Anesthetist, Certified Registered | 4741 Eagleridge Circle, 206, Pueblo, CO 81008 | 2016-01-29 |
| 1407211931 | Center At Park West, LLC | Skilled Nursing Facility | 3727 Parker Blvd., Pueblo, CO 81008 | 2015-12-29 |
| 1417327461 | Nicole Betts | Registered Nurse | 1310 Fortino Blvd Ste D, Pueblo, CO 81008 | 2015-10-02 |
| 1437578028 | Pueblo Modern Dentistry and Orthodontics, LLP | Dentist | 727 Us Hwy 50 West, Pueblo, CO 81008 | 2014-04-10 |
| Find all providers in zip 81008 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932708872 | Carla E Paredes Diaz | Nurse Practitioner | 2215 South Dr, Pueblo, CO 81008-1755 | 2020-10-21 |
| 1902435506 | Brandi Lanae Trujillo | Nurse Practitioner | 3107 E Spaulding Ave Unit 202, Pueblo, CO 81008-5219 | 2020-04-06 |
| 1346883097 | Parkview Ancillary Services | Nurse Practitioner | 1600 N Grand Ave Ste 210, Pueblo, CO 81003-2749 | 2019-10-25 |
| 1326535618 | Amanda Michelle Meade | Nurse Practitioner | 201 Lamkin St Apt 101, Pueblo, CO 81003-3558 | 2018-04-23 |
| 1316456981 | Amy R Leibli | Nurse Practitioner | 1080 Chinook Lane, Pueblo, CO 81001 | 2017-09-26 |
| 1255865713 | Ideal Family Medicine, Ltd | Nurse Practitioner | 2016 S Pueblo Blvd, Pueblo, CO 81005-2546 | 2017-04-11 |
| 1154861995 | Jade Bryant | Nurse Practitioner | 1910 Lake Ave, Pueblo, CO 81004-3322 | 2017-02-27 |
| 1558811950 | Jane Graham | Nurse Practitioner | 1225 N Grand Ave, Pueblo, CO 81003-2845 | 2016-10-10 |
| 1124397559 | Michelle Leann Hartke | Nurse Practitioner | 1619 N Greenwood St Ste 208, Pueblo, CO 81003-2656 | 2011-12-14 |
| 1609008796 | Laura Ann Mcmahon | Nurse Practitioner | 4020 Jerry Murphy Rd/, Pueblo, CO 81001 | 2009-08-21 |
| Find all providers in PUEBLO | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.