Provider Demographics
NPI:1902176704
Name:PRAIRIE VIEW FAMILY CARE, LLC
Entity Type:Organization
Organization Name:PRAIRIE VIEW FAMILY CARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FAMILY NURSE PRACTITIONER/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KAREN
Authorized Official - Middle Name:JILL
Authorized Official - Last Name:MIGLIACCIO
Authorized Official - Suffix:
Authorized Official - Credentials:FNP-C
Authorized Official - Phone:719-661-5886
Mailing Address - Street 1:7641 MCLAUGHLIN RD
Mailing Address - Street 2:
Mailing Address - City:FALCON
Mailing Address - State:CO
Mailing Address - Zip Code:80831-4715
Mailing Address - Country:US
Mailing Address - Phone:719-661-5886
Mailing Address - Fax:
Practice Address - Street 1:7641 MCLAUGHLIN RD
Practice Address - Street 2:
Practice Address - City:FALCON
Practice Address - State:CO
Practice Address - Zip Code:80831-4715
Practice Address - Country:US
Practice Address - Phone:719-661-5886
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-01-10
Last Update Date:2012-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care