Healthcare Provider Details

I. General information

NPI: 1285806927
Provider Name (Legal Business Name): CHERYL CLAIRE CROSBY RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/01/2008
Last Update Date: 04/01/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2820 13TH ST
BOULDER CO
80304-3518
US

IV. Provider business mailing address

714 CARDINAL DR
LAFAYETTE CO
80026-2111
US

V. Phone/Fax

Practice location:
  • Phone: 303-440-5140
  • Fax:
Mailing address:
  • Phone: 303-926-0246
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number95177
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: