Fahrbach, Marissa Lee

Fahrbach, Marissa Lee is an sole proprietor health care provider with primary practice located at 1755 48Th St Ste 100 , Boulder CO 80301-2712. She recently has 2 registered licenses in different health care specialties including Nursing Service Providers / Registered Nurse, Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered. Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered is her primary health care specialty. Fahrbach, Marissa Lee can be contacted via phone (303) 604-5000.

Contact Information

Primary practice address
1755 48Th St Ste 100 Boulder CO 80301-2712
Phone: (303) 604-5000
Fax: (720) 890-0364
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Nursing Service Providers / Registered Nurse 163W00000X 103068 Kansas
Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered 367500000X 557356 Kansas
Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered 367500000X 0994226 Colorado

Profile Details

NPI number 1427430032
LBN Legal business name Fahrbach, Marissa Lee
Credentials
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jun 19th, 2015
Last updated Mar 5th, 2020 - about 6 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1427430032 NPPES
Colorado MEDICAID 9000171761

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