| Blue Nile Clinic | |
|
11275 E Mississippi Ave Ste 2s3 Aurora CO 80012-2825 | |
| (720) 400-4412 | |
| Not Available |
| Full Name | Blue Nile Clinic |
|---|---|
| Speciality | Family Medicine |
| Location | 11275 E Mississippi Ave Ste 2s3, Aurora, Colorado |
| Authorized Official Name and Position | Hana Mengesha (OWNER) |
| Authorized Official Contact | 7204004412 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Blue Nile Clinic 11275 E Mississippi Ave Ste 2s3 Aurora CO 80012-2825 Ph: (720) 400-4412 | Blue Nile Clinic 11275 E Mississippi Ave Ste 2s3 Aurora CO 80012-2825 Ph: (720) 400-4412 |
| NPI Number | 1346763448 |
|---|---|
| Provider Enumeration Date | 07/20/2017 |
| Last Update Date | 07/21/2022 |
| Medicare PECOS PAC ID | 0244622405 |
|---|---|
| Medicare Enrollment ID | O20220120000094 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1346763448 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Bob S Worley |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1811927510 PECOS PAC ID: 0547160673 Enrollment ID: I20040515000313 |
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