Basic Information
| Provider Information | |||||||||
| NPI: | 1194762302 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | CARUSO-HILL | ||||||||
| FirstName: | GEORGIANA | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | MS. | ||||||||
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| Credential: | APRN | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 88 | ||||||||
| Address2: | |||||||||
| City: | WOODLAND PARK | ||||||||
| State: | CO | ||||||||
| PostalCode: | 808660088 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3036951338 | ||||||||
| FaxNumber: | 7196867583 | ||||||||
| Practice Location | |||||||||
| Address1: | 13650 E MISSISSIPPI AVE | ||||||||
| Address2: | 100-B | ||||||||
| City: | AURORA | ||||||||
| State: | CO | ||||||||
| PostalCode: | 800123561 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3036951338 | ||||||||
| FaxNumber: | 3036958814 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/31/2006 | ||||||||
| LastUpdateDate: | 06/28/2013 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 163W00000X | 115122 | CO | N | Nursing Service Providers | Registered Nurse | 363LF0000X | 115122 | CO | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Family |
ID Information
| ID | Type | State | Issuer | Description | 57434034 | 05 | CO | MEDICAID |