Healthcare Provider Details

I. General information

NPI: 1962710400
Provider Name (Legal Business Name): TRACY LYNN YOUSE F.N.P.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/17/2010
Last Update Date: 05/20/2024
Certification Date: 05/20/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1900 WARDENBURG DRIVE 119 UCB WARDENBURG
BOULDER CO
80309-0001
US

IV. Provider business mailing address

1900 WARDENBURG DRIVE 119 UCB WARDENBURG
BOULDER CO
80309-0001
US

V. Phone/Fax

Practice location:
  • Phone: 303-492-5101
  • Fax: 303-492-6861
Mailing address:
  • Phone: 303-492-5101
  • Fax: 303-492-6861

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberNP10327
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: