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NPI Code Detail

MEDICARE: PEGGY A BORDEN RN, BSN

MEDICARE: PEGGY A BORDEN RN, BSN
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
1163W00000XRegistered NurseRN.0199020CO

General Provider Information

NPI Number : 1093116550
Entity Type Code : Individual
Provider Name (Legal Business Name) : PEGGY A BORDEN RN, BSN
Provider Business Mailing Address
First Line : 4856 INNOVATION DR STE B
Second Line :
City : FORT COLLINS
State : CO
Zip : 80525-5540
Country : US
Telephone Number : 970-494-4200
Fax Number :
Provider Business Practice Location Address
First Line : 2001 S SHIELDS ST STE G
Second Line :
City : FORT COLLINS
State : CO
Zip : 80526-1834
Country : US
Telephone Number : 970-494-4200
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/15/2014
Last Update Date : 05/29/2019

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