GRACE LAILA WOERN (NPI# 1871005249) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1871005249 |
| Entity Type | Individual |
| Full Name | GRACE LAILA WOERN |
| Practice Address |
2200 Bonforte Blvd Pueblo CO 81001-4901 |
| Mailing Address |
4239 Charing Cross Cir Anchorage AK 99504-4427 |
| Practice Telephone | 9073060466 |
| Enumeration Date | 2017-10-25 |
| Last Update Date | 2017-10-25 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 2255A2300X |
Specialist/Technologist Specialization: Athletic Trainer |
Respiratory, Developmental, Rehabilitative and Restorative Service Providers | ||
| Y | 390200000X | Student in an Organized Health Care Education/Training Program | Student, Health Care |
| Street Address |
2200 BONFORTE BLVD |
| City | PUEBLO |
| State | CO |
| Zip Code | 81001-4901 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841263597 | Marie Lena Pickerill | Specialist | 2200 Bonforte Blvd, Pueblo, CO 81001-4901 | 2006-02-10 |
| 1538760533 | Angelica Nava | Specialist/Technologist | 2200 Bonforte Blvd, Pueblo, CO 81001-4901 | 2020-11-05 |
| 1689229718 | Christina Marie Shepard | Specialist/Technologist | 2200 Bonforte Blvd, Pueblo, CO 81001-4901 | 2019-08-06 |
| 1588166524 | Daniel C Rodgers | Specialist/Technologist | 2200 Bonforte Blvd, Pueblo, CO 81001-4901 | 2018-03-06 |
| 1255845236 | Hannah Maria Comstock | Student in an Organized Health Care Education/Training Program | 2200 Bonforte Blvd, Pueblo, CO 81001-4901 | 2017-11-29 |
| 1265946388 | Tessa Boccumini | Specialist/Technologist | 2200 Bonforte Blvd, Pueblo, CO 81001-4901 | 2017-11-28 |
| 1124530555 | Natasha Balcom | Specialist/Technologist | 2200 Bonforte Blvd, Pueblo, CO 81001-4901 | 2017-10-25 |
| 1336651751 | Isabella Rose Lopez | Specialist/Technologist | 2200 Bonforte Blvd, Pueblo, CO 81001-4901 | 2017-10-25 |
| 1699287011 | Sierra Berger | Specialist/Technologist | 2200 Bonforte Blvd, Pueblo, CO 81001-4901 | 2017-10-25 |
| 1598277915 | Marc Anthony Cannella | Specialist/Technologist | 2200 Bonforte Blvd, Pueblo, CO 81001-4901 | 2017-10-25 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588222863 | 1111 Bonforte Opco LLC | Respite Care | 855 Hunter Dr., Pueblo, CO 81001 | 2019-06-03 |
| 1992276026 | Andrew Benjamin Basham | Counselor | 1003 Rupple St Pueblo Co 81001, 606, Pueblo, CO 81001 | 2018-12-16 |
| 1316456981 | Amy R Leibli | Nurse Practitioner | 1080 Chinook Lane, Pueblo, CO 81001 | 2017-09-26 |
| 1457781262 | Ron Concialdi | Dentist | 2037 Jerry Murphy Rd., Pueblo, CO 81001 | 2013-11-14 |
| 1609146950 | Natasha Liette Mondragon | Registered Nurse | 1302 E. 5th, Pueblo, CO 81001 | 2012-01-04 |
| 1023303575 | Malinda Lee Davis | Registered Nurse | 1302 E 5th, Pueblo, CO 81001 | 2011-06-13 |
| 1679876429 | Michael Edward Leyba | Substance Abuse Rehabilitation Facility | 4 Montebello Rd., Pueblo, CO 81001 | 2010-12-17 |
| 1609008796 | Laura Ann Mcmahon | Nurse Practitioner | 4020 Jerry Murphy Rd/, Pueblo, CO 81001 | 2009-08-21 |
| 1730380882 | Corrine Stella Tafoya | Counselor | 44 Calhoun Rd, Pueblo, CO 81001 | 2007-05-29 |
| 1518171008 | George Henry Beck | Dentist | 1700 N Salem Ave, Suite A, Pueblo, CO 81001 | 2007-05-10 |
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| Taxonomy Code | 390200000X |
| Grouping | Student, Health Care |
| Classification | Student in an Organized Health Care Education/Training Program |
| An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care. |
| Notes: [1/1/2005: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164042016 | Sunil Kumar | Student in an Organized Health Care Education/Training Program | Parkview Adult Medicine Clinic, 311 West 14th Street, Pueblo, CO 81003 | 2020-04-21 |
| 1003276528 | Rachel Elizabeth Black | Student in an Organized Health Care Education/Training Program | 5306 Outlook Blvd Unit 101, Pueblo, CO 81008-1399 | 2016-02-25 |
| 1487041331 | Joshua Jay Borer | Student in an Organized Health Care Education/Training Program | 786 N Boyero Ave, Pueblo, CO 81007-1299 | 2015-04-17 |
| 1811598907 | Amira Bakkar | Student in an Organized Health Care Education/Training Program | 311 W 14th St, Pueblo, CO 81003-2705 | 2020-11-04 |
| 1497373682 | Manaquibb Zain Ali Shaheer Khan | Student in an Organized Health Care Education/Training Program | 311 W 14th St, Pueblo, CO 81003-2705 | 2020-07-14 |
| 1154949584 | Sohaib Ahmed Khan | Student in an Organized Health Care Education/Training Program | 311 W 14th St, Pueblo, CO 81003-2705 | 2020-07-13 |
| 1427678986 | Blayne Anne Knapp | Student in an Organized Health Care Education/Training Program | 311 W 14th St, Pueblo, CO 81003-2705 | 2020-04-24 |
| 1881214567 | Nathan S Grigg | Student in an Organized Health Care Education/Training Program | 400 W 16th St, Pueblo, CO 81003-2745 | 2020-04-22 |
| 1053931980 | David Allen Mcmillan | Student in an Organized Health Care Education/Training Program | 311 W 14th St, Pueblo, CO 81003-2705 | 2020-04-21 |
| 1699395822 | Neil Ashok Patel | Student in an Organized Health Care Education/Training Program | 311 W 14th St, Pueblo, CO 81003-2705 | 2020-04-17 |
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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.