MRS. LISA LALLIER BLACKWELDER (NPI# 1396990164) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1396990164 |
| Entity Type | Individual |
| Full Name | MRS. LISA LALLIER BLACKWELDER |
| Credential | FNP |
| Practice Address |
2139 N Academy Blvd Colorado Springs CO 80909-1507 |
| Practice Telephone | 7195501172 |
| Practice Fax Number | 7194004803 |
| Mailing Telephone | 7195501172 |
| Mailing Fax Number | 7194004803 |
| Enumeration Date | 2008-11-20 |
| Last Update Date | 2020-10-21 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
APN.0992320-NP | CO | Physician Assistants & Advanced Practice Nursing Providers |
| N | 363LF0000X |
Nurse Practitioner Specialization: Family |
579092 | TX | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TX | TRICARE | 75-2616977-002 | 01 |
| TX | FAMILY NURSE PRACTITIONER | 579092 | 01 |
| TX | TRICARE | 7508181567022 | 01 |
| TX | 070853903 | 05 | |
| TX | TRICARE | 75-2616977-001 | 01 |
| TX | TRICARE | 75-2616977-028 | 01 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 1263 Lake Plaza Dr Ste 120, Colorado Springs, CO 80906 | 7197763330 | 7197763349 |
| 3455 Ringsby Ct Ste 102, Denver, CO 802164923 | 3035001518 | 7205980440 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386109528 | Lisa Victoria Blackwelder | Registered Nurse | 924 Audra St, Cedar Park, TX 78613-7102 | 2019-02-01 |
| Street Address |
2139 N ACADEMY BLVD |
| City | COLORADO SPRINGS |
| State | CO |
| Zip Code | 80909-1507 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023018900 | Deborah A Sullivan | Nurse Practitioner | 2139 N Academy Blvd, Colorado Springs, CO 80909-1507 | 2005-07-21 |
| 1275142390 | Allinfamilymed | Clinic/Center | 2139 N Academy Blvd, Colorado Springs, CO 80909-1507 | 2020-07-24 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376173765 | Ascent Health LLC | Community/Behavioral Health | 2608 Palmer Park Blvd., Colorado Springs, CO- COLORADO 80909 | 2020-01-24 |
| 1639714041 | Peak Vista Community Health Centers | Clinic/Center | 4041 E San Miguel St, Colorado Springs, CO 80909 | 2019-11-08 |
| 1437706231 | Cvs Pharmacy Inc | Durable Medical Equipment & Medical Supplies | 445 N Circle Drive, Colorado Springs, CO 80909 | 2019-08-26 |
| 1760952964 | James Garofalo | Counselor | 2210 E La Salle St Ste 221, Colorado Spgs, CO 80909 | 2018-11-29 |
| 1144719055 | Autumn Leaves Counseling, LLC | Counselor | 2130 Academy Circle, Suite B, Co Springs, CO 80909 | 2018-05-07 |
| 1407353642 | Ambulnz Co, LLC | Ambulance | 2420 E Pikes Peak Ave Ste 1001, Colorado Springs, CO 80909 | 2018-04-12 |
| 1083117998 | Peak Wellness Counseling Service, LLC | Counselor | 2210 E. La Salle Street, Suite 208, Colorado Springs, CO 80909 | 2018-03-16 |
| 1043740822 | Ande Carol West | Dental Hygienist | 701 Citadel Drive East, Colorado Springs, CO 80909 | 2017-06-14 |
| 1043748791 | Colorado Springs Pharmacy LLC | Pharmacy | 2224 E. Pikes Peak Ave, Colorado Springs, CO 80909 | 2017-05-25 |
| 1215484365 | Brittney Nicole Roberts | Physical Therapist | 2201 Lelaray St., Colorado Springs, CO 80909 | 2016-09-07 |
| Find all providers in zip 80909 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013517879 | Melanie Bjorkman | Nurse Practitioner | 8316 Needle Drop Ct, Colorado Springs, CO 80908-1337 | 2020-10-29 |
| 1932708013 | Lindsay Sweetman | Nurse Practitioner | 3575 Rocky Knoll Dr, Colorado Springs, CO 80920-4219 | 2020-10-20 |
| 1922607357 | Laura Evelyn Pettit | Nurse Practitioner | 7114 Selfridge St, Colorado Springs, CO 80916-5296 | 2020-10-16 |
| 1962011452 | Minuteclinic Diagnostic of Colorado LLC | Nurse Practitioner | 3475 N Academy Blvd, Colorado Springs, CO 80917-5166 | 2020-07-30 |
| 1760008999 | Ruth-ann N Umana | Nurse Practitioner | 3550 Plantation Grv, Colorado Springs, CO 80920-4830 | 2020-06-23 |
| 1376169763 | Shannon Graves | Nurse Practitioner | 4964 Bluestem Dr, Colorado Springs, CO 80917-1306 | 2020-06-22 |
| 1487270807 | Tammy Michelle Williams | Nurse Practitioner | 10212 Hannaway Dr, Colorado Springs, CO 80924-5320 | 2020-06-22 |
| 1154947836 | Roni-sue Ranae Westermeyer | Nurse Practitioner | 560 Hidden Cottage Grv, Colorado Springs, CO 80906-7777 | 2020-06-18 |
| 1952937906 | Brena Jonsan Branch | Nurse Practitioner | 5556 Prairie Schooner Dr, Colorado Springs, CO 80923-8771 | 2020-03-20 |
| 1235764390 | Serenity Clouds Family Practice Pllc | Nurse Practitioner | 13395 Voyager Pkwy Ste 446, Colorado Springs, CO 80921-7676 | 2020-03-10 |
| Find all providers in COLORADO SPRINGS | ||||
| City | COLORADO SPRINGS |
| Zip Code | 80909 |
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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.