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NPI Code Detail

MEDICARE: SHELLY LYNN DUFF RN

MEDICARE: SHELLY LYNN DUFF RN
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1163WS0121XPlastic Surgery Registered Nurse150683CO

General Provider Information

NPI Number : 1083971873
Entity Type Code : Individual
Provider Name (Legal Business Name) : SHELLY LYNN DUFF RN
Provider Business Mailing Address
First Line : 5901 CORPORATE DR
Second Line :
City : COLORADO SPRINGS
State : CO
Zip : 80919-1941
Country : US
Telephone Number : 719-355-1956
Fax Number : 719-355-1958
Provider Business Practice Location Address
First Line : 5901 CORPORATE DR
Second Line :
City : COLORADO SPRINGS
State : CO
Zip : 80919-1941
Country : US
Telephone Number : 719-355-1956
Fax Number : 719-355-1958
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/18/2012
Last Update Date : 04/18/2012

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