MR. LEE FONSECA (NPI# 1831258367) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1831258367 |
| Entity Type | Individual |
| Full Name | MR. LEE FONSECA |
| Credential | NP-C |
| Practice Address |
4112 Outlook Blvd Suite 37 Pueblo CO 81008-1667 |
| Practice Telephone | 7195626254 |
| Practice Fax Number | 7195626255 |
| Mailing Telephone | 7195626254 |
| Mailing Fax Number | 7195626255 |
| Enumeration Date | 2006-12-08 |
| Last Update Date | 2015-01-07 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
105831 | CO | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CO | 92354378 | 05 |
| Street Address |
4112 OUTLOOK BLVD SUITE 37 |
| City | PUEBLO |
| State | CO |
| Zip Code | 81008-1667 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447233432 | Richard N. Nanes | Emergency Medicine | 4112 Outlook Blvd, Suite 37, Pueblo, CO 81008-1667 | 2005-11-22 |
| 1487262689 | Patricia A Turner | Nurse Practitioner | 4112 Outlook Blvd, Pueblo, CO 81008-1667 | 2020-07-14 |
| 1932648490 | Jordan T. Rhodes | Physical Therapist | 4112 Outlook Blvd, Pueblo, CO 81008-1667 | 2017-02-16 |
| 1952769812 | Samantha Correia | Physical Therapist | 4112 Outlook Blvd, Pueblo, CO 81008-1667 | 2016-02-08 |
| 1003295346 | Karen Bishop | Physical Therapist | 4112 Outlook Blvd, Ste 96, Pueblo, CO 81008-1667 | 2015-05-19 |
| 1871992321 | Ryanne Leah Gromatzky | Physical Therapist | 4112 Outlook Blvd, 96, Pueblo, CO 81008-1667 | 2014-08-21 |
| 1801218284 | Pamela Drummond | Registered Nurse | 4112 Outlook Blvd, Suite 37, Pueblo, CO 81008-1667 | 2014-01-20 |
| 1568896959 | Sarah Elizabeth Whiteman | Physical Therapist | 4112 Outlook Blvd, Suite 96, Pueblo, CO 81008-1667 | 2013-08-21 |
| 1336487297 | Leslie Dallas | Physical Therapist | 4112 Outlook Blvd, Suite 96, Pueblo, CO 81008-1667 | 2013-01-27 |
| 1780942441 | Betty Ann Massino | Massage Therapist | 4112 Outlook Blvd, Suite #96, Pueblo, CO 81008-1667 | 2012-05-01 |
| Find all providers in the same location | ||||
| 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 |
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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.