Provider Demographics
NPI:1053760017
Name:FAIRMONT, LORRAINE HIGBIE (CNM, MSN, CLC)
Entity type:Individual
Prefix:MRS
First Name:LORRAINE
Middle Name:HIGBIE
Last Name:FAIRMONT
Suffix:
Gender:F
Credentials:CNM, MSN, CLC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
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Mailing Address - Street 1:5277 MANHATTAN CIR
Mailing Address - Street 2:#102
Mailing Address - City:BOULDER
Mailing Address - State:CO
Mailing Address - Zip Code:80303-8201
Mailing Address - Country:US
Mailing Address - Phone:303-817-6615
Mailing Address - Fax:303-447-0859
Practice Address - Street 1:5277 MANHATTAN CIR
Practice Address - Street 2:#102
Practice Address - City:BOULDER
Practice Address - State:CO
Practice Address - Zip Code:80303-8201
Practice Address - Country:US
Practice Address - Phone:303-817-6615
Practice Address - Fax:303-447-0859
Is Sole Proprietor?:No
Enumeration Date:2016-06-09
Last Update Date:2016-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO83839163W00000X
COAPN0001167-CNM367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife
No163W00000XNursing Service ProvidersRegistered Nurse