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NPI Code Detail

MEDICARE: GINA JUSTUS APRN,FNP-C

MEDICARE: GINA JUSTUS APRN,FNP-C
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
1363LF0000XFamily Nurse Practitioner5512CO

General Provider Information

NPI Number : 1780705699
Entity Type Code : Individual
Provider Name (Legal Business Name) : GINA JUSTUS APRN,FNP-C
Provider Business Mailing Address
First Line : 2550 TENDERFOOT HILL ST
Second Line :
City : COLORADO SPRINGS
State : CO
Zip : 80906-3998
Country : US
Telephone Number : 719-574-7083
Fax Number :
Provider Business Practice Location Address
First Line : 1050S ACADEMY BLVD 140
Second Line :
City : COLORADO SPRINGS
State : CO
Zip : 80910-3922
Country : US
Telephone Number : 719-574-7083
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/02/2007
Last Update Date : 02/14/2017

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Directions to “ GINA JUSTUS APRN,FNP-C” Practice Location

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