Healthcare Provider Details

I. General information

NPI: 1912020348
Provider Name (Legal Business Name): RHONDA MARIE JUDGE CSFA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/09/2007
Last Update Date: 05/19/2020
Certification Date: 05/19/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2601 S MILWAUKEE ST
DENVER CO
80210-6216
US

IV. Provider business mailing address

2601 S MILWAUKEE ST
DENVER CO
80210-6216
US

V. Phone/Fax

Practice location:
  • Phone: 303-619-9625
  • Fax: 303-722-2101
Mailing address:
  • Phone: 303-722-9808
  • Fax: 303-722-2101

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code246ZC0007X
TaxonomySurgical Assistant
License Number0001018
License Number StateCO
# 2
Primary TaxonomyN
Taxonomy Code246ZS0410X
TaxonomySurgical Technologist
License Number82439
License Number StateCO
# 3
Primary TaxonomyY
Taxonomy Code246ZC0007X
TaxonomySurgical Assistant
License NumberSA.0001018
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: