MRS. LISA CLOUGH (NPI# 1841459690) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1841459690 |
| Entity Type | Individual |
| Full Name | MRS. LISA CLOUGH |
| Credential | FNP |
| Practice Address |
3676 Parker Blvd Suite 260 Pueblo CO 81008-2212 |
| Mailing Address |
Po Box 9000 Pueblo CO 81008-9000 |
| Practice Telephone | 7195532201 |
| Practice Fax Number | 7195532224 |
| Mailing Telephone | 7195532200 |
| Mailing Fax Number | 7195532216 |
| Enumeration Date | 2008-06-06 |
| Last Update Date | 2008-06-06 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
5716 | CO | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CO | STATE LISCENSE | 5716 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780787697 | Lisa A Clough | Internal Medicine | 3901 Rainbow Boulevard, 6067 Delp, Mail Stop 1028, Kansas City, KS 66160 | 2006-09-06 |
| Street Address |
3676 PARKER BLVD SUITE 260 |
| City | PUEBLO |
| State | CO |
| Zip Code | 81008-2212 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922001700 | Stephen D Bast | Physician Assistant | 3676 Parker Blvd, Pueblo, CO 81008-2212 | 2005-05-24 |
| 1255945960 | Jessica Marie Anaya | Nurse Practitioner | 3676 Parker Blvd, Pueblo, CO 81008-2212 | 2020-09-01 |
| 1023658713 | Havilah R. Spurlock | Nurse Practitioner | 3676 Parker Blvd, Pueblo, CO 81008-2212 | 2020-01-09 |
| 1033625314 | Jennifer Livingston | Nurse Practitioner | 3676 Parker Blvd, Pueblo, CO 81008-2212 | 2017-12-21 |
| 1588176341 | Kenneth Morris | Physical Medicine & Rehabilitation | 3676 Parker Blvd, Pueblo, CO 81008-2212 | 2017-11-01 |
| 1053770370 | Parkview Medical Center, Inc | Clinic/Center | 3676 Parker Blvd, Suite 140, Pueblo, CO 81008-2212 | 2016-02-15 |
| 1124495163 | Kyle Sanders | Physical Therapist | 3676 Parker Blvd, Suite 370, Pueblo, CO 81008-2212 | 2015-08-25 |
| 1588057319 | James Richard Anderson | Physician Assistant | 3676 Parker Blvd, Pueblo, CO 81008-2212 | 2015-03-18 |
| 1942600150 | Adam Jennings | Physical Therapist | 3676 Parker Blvd, Suite 370, Pueblo, CO 81008-2212 | 2014-08-26 |
| 1023425386 | Amanda C Fadenrecht | Nurse Practitioner | 3676 Parker Blvd, Suite 260, Pueblo, CO 81008-2212 | 2014-07-18 |
| 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 |
| Find all providers in PUEBLO | ||||
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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.