Healthcare Provider Details

I. General information

NPI: 1053845446
Provider Name (Legal Business Name): JULIA BYRNE RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/12/2017
Last Update Date: 04/12/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

46 SUTTLE ST
DURANGO CO
81303-7947
US

IV. Provider business mailing address

7155 E 38TH AVE
DENVER CO
80207-1630
US

V. Phone/Fax

Practice location:
  • Phone: 970-247-3002
  • Fax: 970-382-0328
Mailing address:
  • Phone: 303-321-7526
  • Fax: 303-861-0268

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN.1641610
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: