| Debra B Fitzgibbons Lswii Pc | |
|
6676 Gunpark Dr Ste E Boulder CO 80301-3352 | |
| (303) 443-0089 | |
| Not Available |
| Full Name | Debra B Fitzgibbons Lswii Pc |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 6676 Gunpark Dr Ste E, Boulder, Colorado |
| Authorized Official Name and Position | Debra B. Fitzgibbons (PRESIDENT) |
| Authorized Official Contact | 3034430089 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Debra B Fitzgibbons Lswii Pc 6676 Gunpark Dr Ste E Boulder CO 80301-3352 Ph: (303) 443-0089 | Debra B Fitzgibbons Lswii Pc 6676 Gunpark Dr Ste E Boulder CO 80301-3352 Ph: (303) 443-0089 |
| NPI Number | 1831761964 |
|---|---|
| Provider Enumeration Date | 07/16/2021 |
| Last Update Date | 07/16/2021 |
| Certification Date | 07/15/2021 |
| Medicare PECOS PAC ID | 5496159303 |
|---|---|
| Medicare Enrollment ID | O20210813001036 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1831761964 | NPI | - | NPPES |
| 1639378698 | Other | CO | ANTHEM |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
| Provider Name | Debra B Fitzgibbons |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1639378698 PECOS PAC ID: 6002210929 Enrollment ID: I20210813001334 |
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