Healthcare Provider Details

I. General information

NPI: 1497986129
Provider Name (Legal Business Name): JOANNE MONTERROSO AZPURU MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/29/2009
Last Update Date: 08/04/2023
Certification Date: 08/04/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6767 29TH ST FL 1
GREELEY CO
80634-5474
US

IV. Provider business mailing address

6767 29TH ST FL 1
GREELEY CO
80634-5474
US

V. Phone/Fax

Practice location:
  • Phone: 970-652-2780
  • Fax: 970-652-2797
Mailing address:
  • Phone: 970-652-2780
  • Fax: 970-652-2797

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RH0003X
TaxonomyHematology & Oncology Physician
License Number58817
License Number StateMN
# 2
Primary TaxonomyY
Taxonomy Code207RX0202X
TaxonomyMedical Oncology Physician
License NumberDR.0070754
License Number StateCO
# 3
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberDR.0070754
License Number StateCO
# 4
Primary TaxonomyN
Taxonomy Code207RH0000X
TaxonomyHematology (Internal Medicine) Physician
License NumberDR.0070754
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: